Podcast Sponsor/Announcer (3:39)

If you're in private practice, you wear a lot of hats. And some of those hats are totally great. But some like filing taxes and running payroll for example, not so great. That's where Gusto comes in. They make payroll taxes and HR actually easy for small businesses like your private practice. Fast, simple payroll processing and benefits and expert HR support all in one place. Gusto automatically pays and files your federal, state and local taxes so you don't have to worry about it. Plus they make it easy for you to add on health benefits and even 401ks for you and your team. Let them wear one of your many hats. You have so many better things to do with your time. Listeners get three months free when they run their first payroll. Try a demo and see for yourself@gusto.com pps that's gusto.com pps there are so many ways to keep your practice organized, but TherapyNotes is by far the best. Their easy to use secure platform lets you not only do billing, scheduling and progress notes, but also create a client portal to share documents and request signatures. Plus they offer amazing unlimited phone support. So when you have a question, they're there so you can get help fast. Get started with TherapyNotes today, trusted by over 60,000 professionals. Go to therapynotes.com and enter promo code PPS as in Private Practice Startup and you'll get two months for free. Also, you can listen to episode 54 where we interviewed Brad Pliner and took an in depth view into their ehr.

Perry Rosenblum (5:11)

In this episode of the Therapist Experience, I'm speaking with Katie Lemieux from the private practice startup. This is the Therapist experience, episode number 180. Welcome to the Therapist Experience, the podcast where we interview successful therapists about what it's really like starting and growing a. I'm Perry Rosenblum, the founder of Brighter Vision, and I am so excited to introduce our guest today, my good friend, Katie Lemieux. Katie, how you doing today?

Katie Lemieux (5:43)

Well, like before, we hit record, a little, you know, up and down, uneasy at some times and sometimes totally okay. So right now in this moment, I'm okay. How are you, Barry?

Perry Rosenblum (5:53)

Right now, in this moment, I'm okay as well. You know, I'm. We're recording this as the COVID 19 outbreak is really just starting to take hold in America. You know, I'm nervous for my friends and family back in New York. I'm nervous for our clients and the clients they serve around the country and around the world. But, you know, like Katie and I were saying before we got started today, we need to talk about how we can help therapists and how we can help therapists better help people, because this is uncertain world and an uncertain environment. And I know I'm feeling a lot of anxiety and a lot of. A lot of feelings that I can't even articulate properly. I know, Katie, you are as well. I'm sure our audience is as well. And if all of us are who are in the mental health space, we know that your clients are feeling it as well. And so Katie and I have come together today to chat about things you can be doing as a therapist, as a business owner to better help your clients transition to telehealth and provide them with the help that they need to get through these incredibly challenging times. So, Kati, thank you for joining me today.

Katie Lemieux (7:06)

Thanks for having me.

Perry Rosenblum (7:09)

Okay, so, you know, where do we begin here, Katie? Should we start off? Let's talk about telehealth.

Katie Lemieux (7:18)

Yeah, let's do that.

Perry Rosenblum (7:20)

All right, so by now, hopefully everybody listening to this podcast has transitioned fully to telehealth. And let's talk about some of the challenges that telehealth can pose for a business owner and then also for, you know, your private practice itself and your clients. Katie, what are you seeing in talking with your clients and seeing on the Facebook groups right now that you're.

Katie Lemieux (7:42)

You're in so what's interesting is, you know, Kate and I have been talking about telehealth for a while. You know, we have our attorney approved private practice paperwork and we had created technology assisted counseling consent. So we've kind of been immersed in this for a while. But with everything happening in, you know, the COVID crisis, things are changing very rapidly on a day to day basis. Right now that we're all at home and going online. One of the challenges that I'm hearing is sometimes like some of the free platforms is they're not working as well. People are either having to upgrade or utilize different things. I saw a day or two ago that the ocr, which rules like HIPAA and all the HIPAA guidelines is now at this time of the crisis, you know, loosening the penalties or not doing penalties if therapist with good intention. Right. And we're talking about best practices, you know, are deciding to utilize other platforms that aren't necessarily HIPAA compliant. So one of the things, you know, like I always look to the law, right? I always look to the law first and then I kind of go down from there. So this is the reality. During the crisis, you as a therapist might say, absolutely not. I' get on a non HIPAA compliant platform and you have to do what's comfortable for you. And at the same time, when we're in a crisis is we're trying to manage the best that we can. You know, I look at, you know, the hospitals or things that they're obviously getting overloaded and they're, they're creating things in parking lots and stuff like that. And so, you know, you have to just check in with yourself, go with your best practices, follow the law and the rules as they come out and remember that this is for this time of course crisis. Right? This is not like, oh well, because during COVID 19, you know, they said I can use whatever platform, so I'm going to continue to do that is we definitely have to respect the rules and ethics of our profession as well as be able to serve our clients. Because the reality is, is the mental health impacts of all of this. I know that, you know, right now and for the last few weeks people probably been in a state of panic and they're just trying to like stabilize at the moment. And so, you know, clients are canceling or they're not or they're really anxious. But you know, as we stay home and isolation or quarantine is that, you know, there's going to be a lot of stuff that pops up that people are going to need Services for. And so being able to prepare yourself now and be proactive, I feel very grateful that Kate and I just last week spoke with Dr. Gamba from Italy, who helped us kind of be proactive in what it is that's happening. So maybe I can share where she shared that she's at today. So they're three weeks about ahead of us. And you know, after everything has calmed down, there's this sense of peace. So, you know, there's a lot of a range of emotions for ourselves as clinicians, for our clients. We will get through this together. And there's also, in the midst of crisis, great opportunity, you know what I mean? So one of the things, if you haven't educated yourself yet, I know that we have a free online course and Kate and I have been working behind the scenes yesterday and today of creating a resource guide from all your favorite practice builders and supports just like Brighter Vision and so many more of all the different Covid type resources. So educating your. Things like that. So those are some of the things that I'm seeing like mainly about platforms and I think the scramble to get on telehealth quickly and what is the state say and am I supposed to, you know, be certified or an online course? And so definitely checking with your state boards and things like that also helps.

Perry Rosenblum (11:08)

In terms of forms that you as a clinician need to transition to telehealth. What are some changes to forms that a clinician needs to make and where can they find resources about that?

Katie Lemieux (11:24)

Yeah, so of course, you know, if you're having an initial client or a regular client, you want to always have your basic forms for an initial client, which would be, you know, your HIPAA form if you're a covered entity, your biopsych, your regular consent. But one of the things, you know, as we had advanced with, you know, online counseling or technology assisted counseling, is we have created a specific form that is for technology assisted counseling services specifically, because things are a little bit different. Right. When a client is in our room, we can protect their confidentiality. When we're not and we're doing telehealth, we can assure the client's confidentiality. So we have to educate them on how to assure their confidentiality. So there's things as therapists that Kate and I have experienced combined with the ethics and laws, we created this very specific consent to address those things. Like, sometimes people don't even think about it. But, you know, the use of headphones for both the therapist and the client actually creates more confidential. Right. Like if we're just talking through a computer. You know, someone can hear what we're saying on the other end. And the fact that during this crisis, people are going to be home with their families and their kids and things like that is we really have to educate people on this. And there's other benefits to technology assisted counseling for the client as well as the therapist. Right. There's easier access, and obviously that's what we're seeing right now.

Perry Rosenblum (12:45)

One question I have. You brought up a lot of great points there, Katie. One thing I've been seeing are concerns about how to provide telehealth, how to do therapy online to somebody who's in a situation where they cannot have necessarily a safe space in their house to do that. What kind of advice and guidance would you give to our audience that might be, you know, going through this right now?

Katie Lemieux (13:18)

Yeah, so, you know, I think it's important to be flexible as a therapist right now. And sometimes that might be, you know, sessions when the kids are asleep. You can invite your loved ones or whoever's in the house, like, hey, I really need to have this session. Can you like, you know, play outside with the kids or take them for a walk? I think that's important. You know, and historically, maybe if you don't do weekend sessions that you are flexible, if you can. Are you kind of saying more Perry for the client or you're talking about the therapist or both?

Perry Rosenblum (13:52)

In this case, I was speaking specifically about the client. I think for a therapist, you know, you got to be flexible with your hours. You need to be understanding that you're probably going to be having more evening sessions or weekend sessions and that your general day to day is going to be disrupted. But what about clients that can't necessarily have a safe space to do therapy with you? What, what can you be offering to them?

Katie Lemieux (14:14)

Well, one of the things too is telehealth also looks at like email, text and phone. Right. So if they can hop in their car on the phone and speak with you, you know, that's a way to bridge one of the gaps. And that's kind of where the safer space. I wouldn't say put yourself on Bluetooth, because we all know at the stoplight, if someone's next to you, we can hear what's happening. But that would be an op, an opportunity and an option.

Perry Rosenblum (14:38)

Absolutely. And Katie, before you're saying that you guys have a consent form, where would our audience find that?

Katie Lemieux (14:46)

So our consent form is online and you can head over to private practicestartup.com, go over to the paperwork tab. If you just want to purchase that form, go into the a la carte and you'll see the technology assisted counseling and use coupon code Be well B E W E L L for $20 off the form. And you also go ahead and get the free online course that we had created.

Perry Rosenblum (15:11)

Evan oh, thank you so much for offering that. So it's be well for $20 off the course.

Katie Lemieux (15:16)

Great. One for the form and then the course just comes with it.

Perry Rosenblum (15:19)

We'll have a link to that form in this week's show notes@brightervision.com Session 180 Kati what else are you seeing going on in the community for clinicians to be transitioning to telehealth and other struggles that they might be facing?

Katie Lemieux (15:38)

Yeah, one thing that I'm seeing and I'm trying to kind of understand this and talking back and forth with some folks, especially in Florida. So I can only talk about the state of Florida for interns, but in the state of Florida for interns is that interns can have their own private practice. Right. As long as a licensed person is on site while they're providing therapy services. Historically for Florida. Right. Historically for Florida. Is that a clinician, they could provide telehealth services again though, that a licensed clinician needs to be on site but they can't count those hours towards licensure. So obviously some transitions have been made. I keep hearing a little bit of different information. Even though I got like the ruling, I've read through the information, I've contacted the people, like what exactly does this mean? I want to be clear before I share the information. But one of the difficulties is if you are an intern and you're required to have a licensed person on site, number one, what does that look like in the rulings for your state? And number two, what if your state says, well, no, we're just kind of sticking to that. You can't do telehealth because there's not going to be a licensed person on site. The impact on the client, you know, if you're right in the middle, this is not a client that's ready for discharge or termination. Right. Like if you're in the middle of the process, like the impact on the client, the mental health and the well being to cut services off and then try to either transition to a new therapist, you know, I think that's definitely a disservice to clients. And I think as like a community we have to figure out a way to, you know, make that happen for clients to receive continued services because we're in a time of crisis. And that usually ramps up our own emotions and anxieties like all of us are feeling. That's, that's definitely a struggle that I'm seeing and I'm, you know, fingers crossed that the boards are figuring that out on how to clearly continue the continuity of services. Because, you know, in the mental health field, we're always looking at, I guess in the US not every country has licensing boards is the law, the ethics and best practices. Sometimes that stuff goes hand in hand and sometimes it doesn't.

Perry Rosenblum (17:40)

So let's talk about self care here for a minute because the work that you and our audience does can be very taxing at times. And what's going on in the world is incredibly taxing as well right now. So, you know, it's so important that you as a therapist is that you as an entrepreneur are taking some time for self care. You know, make sure that you're getting out, getting some fresh air, going for a walk, keeping that six feet of distance away from anybody. Don't go, don't be mingling socially. You know, go out for a run if you can. You know, make sure that you're taking care of yourself, you're eating well, you're, you're hydrating properly and taking care of yourself through these tough times so that you can take care of your clients as well. You know, one thing that's also really important is, you know, transitioning your website to be a little more telehealth focused and be a little more technology focused. You know, it's really critical that you are positioning yourself online as, you know, being supportive of your clients. Having, you know, a clear message that you are offering. Telehealth now is super important to make sure that you're not only, you know, maintaining your existing relationships with your clients, but also driving in new business right now because there are a lot of people who are still struggling and still looking for help. I'm, I've been seeing on these Facebook groups, so I'd be like, I got six new couples inquiring yesterday, is anybody else's business blowing up? And you're seeing that a lot right now because, you know, people are stressed, people are scared. So make sure that you're communicating on your website that you're providing telehealth services that you have. If you're using a HIPAA compliant platform, that you have a safe and secure platform to provide telehealth to both new and existing clients, blast it loud and clear on your website. That you're taking new clients, you are accepting new clients right now to help them through these times. There's a lot that you can be doing from a marketing standpoint. You know, we talked a lot about that last week's episode on session 179. Just remembering that you are a tech company now. Every business is a tech company now. You need to market yourself like a tech company. So provide value. Provide resources to people in your community. Maybe even offer a free session a week to people who might have been recently unemployed and laid off because they're going to be going through some really hard times, especially those in the food and beverage industry who already have a higher rate of addiction. You know, make sure that you're helping your community through these times so that, you know, givers gain kind of mentality. Right.

Katie Lemieux (20:30)

Perry, I'm curious. I'd love to know a little bit more from you. Like how. What. What people should be doing to prepare their websites to let them know, you know, that they're still offering these services. How can they make that really loud and clear?

Perry Rosenblum (20:44)

Yeah, absolutely. I mean, one thing you should be doing is making sure that your hero image on your website is adjusted so that big image, if you have text overlaid on top of it, make it clear that you are there to help people, that, hey, we are accepting new clients in this time of crisis. We are here to help you get through this time of crisis. We offer telehealth. You know, your entire homepage, at least everything above the fold in the first paragraph or two, should be dedicated to how you've transitioned your private practice to provide telehealth services to people. Your Psychology Today profile, make sure that's adjusted and make it clear that you are providing telehealth. And blast it loud and clear. Put it at the top. Hang on one second. My boys are trying to come in. Not right now, Zach. I knew that I'd get interrupted a podcast one of these days with my boys coming in. Can you close the door, please, buddy? So I keep thinking about that BBC interview where. Where someone's, like, talking about something super serious and his children come in and are, like, doing a little dance behind him. And then his wife was watching him on the interview and then realized that her kid. That their kids were in the room because she saw them on the TV and ran upstairs and scurried them out. Just totally had that kind of moment here. But there's no video, so you couldn't see it anyway.

Katie Lemieux (22:11)

That's a thing you should be doing. That was so Funny. So here's a. Perfect. That's perfect, right? Because when we think about that, it's definitely funny. But here's another tip for telehealth, right? Like if you as a therapist are in a room, is that you would want to make sure that your computer is facing, you know, not where someone can walk in and kind of see your client, but you want to make sure the back of your laptop is facing the door just in case any of those things happen. So these are all the, like, logistic things that now are happening that we, that we have to kind of put in place and think about for sure. And then you can also encourage that with your client. You know what I mean? That they're in a place where obviously they're not going to be interrupted or interrupted. Lock the door. That would be important, right? Being interrupted as little as possible, but like facing the laptop or the phone or something away from where someone can enter.

Perry Rosenblum (23:01)

And these are things you can do on your website as well. You know, have a, you know, prepping for telehealth guide on your website, a single page that, you know, you're outlining what your client should be doing to prep for a telehealth session. You know, you have a safe, secure spot in your house with a. Be able to lock the door. If you don't have one, you know, go into your car. We can do this via the phone, you know, have headsets set up, a headphone setup plugged into your computer. Make sure that your computer's camera is facing a wall so that no one can see what's going on. You can provide this guidance to your client it on a page on your website and emailing that to them, you know, as a reminder about their session so they can prep properly and arrive, quote, unquote, on time for the session. Because on time is different now. You know, before someone just needed to show up in your waiting room and be on time. Now it's, I need to be on time. By God, my kids are coming in again. I need to be on time. And this time they're coming in in a cardboard tank that they built, trying to open the door here so I can't see them. This time on time is being set up so that, you know, you can join and have your session start immediately and have everything plugged in and ready to go immediately. You know, your computer charging, if you're on a laptop, the charger is plugged in and all of that fun stuff. And I'm completely losing my train of thought. This might be the cue for us to kind of wrap things up here as I have a cardboard tank pointing its bazooka at me right now. Oh man. Katie, any parting advice for our listeners? It's good to end things on a positive note, right?

Katie Lemieux (24:54)

Well, one thing I was thinking about as you're saying all of that stuff and I'm not a big person to recreate the wheel, right. So when I think about our consent, it has a lot of that information. So if you do decide to grab the consent, use that for inspiration. Don't copy and paste and make this page on your website. Right. Use it for inspiration because it's easier to just kind of take your own bullet points, make it in your own words in regards to prepping people. And one other thing I think about is, you know, if someone's coming to therapy anyways, their anxieties are high most often. I mean this is how I think about therapy. You're going to a stranger to tell all your dirty dark secrets like who wants to do that? Unless people have already been in therapy for a while and really enjoy it. Most people have anxieties. One of the ways to reduce the anxieties around telehealth and I mean we're moving towards like this is how it just has to be like it's going to be. It's not an option almost anymore for now. Right. But is to actually just do like a preparation with your client. You know, schedule 10, 15 minutes either before the session or outside of the session to get on the platform with them, show them around, show them how it's going to be, what it's going to feel like, answer any questions they have and then hop off. So we have to look at ways to reduce our clients anxiety around moving towards telehealth to really just help them so that they can be focused and present in this session.

Perry Rosenblum (26:12)

Absolutely. Love it. Katie. Katie, thank you so much for coming on the show today to our audience. To learn more about Katie and the private practice startup you are not familiar with them, head on over to priorvision.com session 180. There will be links in this week's show notes as well as a link to the private practice startups technology assisted counseling form with a Coupon code for $20 off. Katie, thank you so much for being on to our audience. Remember this too shall pass. This is not the new normal. We will get through this together. So thank you all for listening and thanks Katie for being on and we'll see you all next week.

Podcast Sponsor/Announcer (26:53)

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.

Perry Rosenblum (27:21)

Sam.