Episode 357: How to Create a Neurodivergent Affirming Private Practice

Summary

Private Practice Startup Podcast - Episode 357 Summary

Title: How to Create a Neurodivergent Affirming Private Practice
Host: Dr. Kate Campbell & Katie Lemieux
Guests: Patrick Sal, Founder of All Things Private Practice & Host of All Things Private Practice Podcast; Maureen Warbach, Visionary Entrepreneur in the Mental Health Field
Release Date: July 27, 2024

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Introduction to the Episode

In Episode 357 of the Private Practice Startup Podcast, hosts Dr. Kate Campbell and Katie Lemieux delve into the essential strategies for creating a neurodivergent-affirming private practice. The episode features returning guests Patrick Sal and Maureen Warbach, both esteemed entrepreneurs in the mental health sector, who share their expertise and personal experiences in fostering inclusive and supportive environments for neurodivergent individuals.

Understanding Neurodivergence in Private Practice

[05:00] Maureen Warbach emphasizes the significance of the episode's timing, noting, “Today is April 10th. We are firmly in the month of autism acceptance month,” highlighting the increasing recognition of neurodiversity in mental health practices.

The Power of Language

One of the foundational elements discussed is the importance of language in affirming neurodivergent identities.

• Maureen Warbach: “Language matters. We need to use identity-first language, such as 'I am an autistic therapist,' rather than 'a therapist with autism.' This shift honors neurodiversity and validates the lived experiences of neurodivergent individuals.”
  [10:00]

• Laura: “Autistic clients want to feel understood without having to explain their challenges in detail. Proper language fosters this immediate sense of understanding and acceptance.”
  [27:50]

Developing Affirming Policies and Procedures

Creating policies that support neurodivergent clients and staff is crucial. The guests discuss practical steps to ensure these policies are both inclusive and effective.

Flexible Scheduling and Accommodations

• Patrick Sal: “During onboarding, we highlight identities and accommodations right away. For example, if a staff member needs to start their day at 2 PM instead of 9 AM, we accommodate that.”
  [08:15]

• Maureen Warbach: “We eliminate rigid schedules, allowing staff to work during their most productive hours. This flexibility reduces stress and enhances job performance.”
  [12:00]

Communication Preferences

• Patrick Sal: “We use communication preference surveys to understand how each team member likes to receive feedback—be it via text, email, or in-person. This ensures everyone feels comfortable and heard.”
  [09:45]

• Maureen Warbach: “Allowing clients to choose how they communicate—whether through video calls with the camera off, texting, or traditional phone calls—can significantly improve their therapy experience.”
  [29:30]

Environment and Sensory Considerations

• Maureen Warbach: “Setting up a sensory-friendly office—like using low lighting and providing fidget tools—helps clients feel more comfortable and present during sessions.”
  [16:50]

Internal Practices for Staff Support

The conversation shifts to internal practices that support neurodivergent staff members, ensuring they thrive within the organization.

Modeling and Advocacy

• Patrick Sal: “Modeling self-advocacy as leaders encourages staff to feel safe in disclosing their neurodivergent identities and requesting necessary accommodations.”
  [34:30]

• Maureen Warbach: “By openly discussing my own needs and preferences, I create a safe space for others to do the same, fostering a supportive and understanding workplace culture.”
  [35:00]

Continuous Improvement and Evolution

Maintaining a neurodivergent-affirming practice is an ongoing process that requires regular reflection and adaptation.

• Patrick Sal: “There’s never an endpoint. Every six months, we review our policies and practices to incorporate new insights and improvements, ensuring we remain inclusive and supportive.”
  [33:55]

• Maureen Warbach: “Constantly evolving our approach helps us stay aligned with the needs of our neurodivergent clients and staff, allowing us to provide the best possible care and support.”
  [33:52]

Personal Stories and Impact

Both guests share personal anecdotes that highlight the transformative impact of adopting neurodivergent-affirming practices.

• Patrick Sal: Reflecting on his own journey, Patrick shares, “Discovering my own neurodivergent identity allowed me to advocate for myself and, in turn, inspire my team to do the same. This has created a more authentic and productive work environment.”
  [17:00]

• Maureen Warbach: Maureen recounts her experience with public rollout of neurodivergent affirming practices, stating, “Modeling acceptance and flexibility in my practice has not only benefited my clients but has also empowered my staff to embrace their true selves, leading to better outcomes for everyone involved.”
  [19:20]

Key Takeaways and Conclusion

The episode concludes with reflections on the importance of embracing neurodiversity within private practices. The guests reiterate that small, intentional changes can make a significant difference in creating an inclusive and supportive environment for both clients and staff.

• Patrick Sal: “Feeling comfortable to self-advocate as a leader creates a ripple effect, fostering a positive and inclusive atmosphere for everyone in the practice.”
  [34:40]

• Maureen Warbach: “Listening to and incorporating feedback from neurodivergent voices is essential. It ensures that practices are truly accessible and affirming.”
  [34:50]

Dr. Kate Campbell and Katie Lemieux thank Patrick and Maureen for their invaluable insights, encouraging listeners to implement these strategies to build neurodivergent-affirming private practices that not only support clients but also empower mental health professionals.

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For More Information:
Visit www.PrivatePracticeStartup.com for additional resources, webinars, online courses, and attorney-approved private practice paperwork.

Transcript

[Katie]

Welcome to the Private Practice Startup Podcast where we help mental health professionals grow their dream practices and live a life they love. We chat with successful private practitioners, business coaches and marketing experts, bringing you tons of practice building tips. We invite you to take advantage of our private practice paperwork and our signature marketing E course. And we have a gift for you. This is the exact methodology we use to create our six figure private pay practices have helped many other therapists do the same. Go to private practicestartup.com and on the homepage click the button to download a free copy of your dream private practice playbook. Now, on to today's episode.

[Laura]

Hey everybody. Welcome back to another episode of the Private Practice Startup Podcast. As always, we are delighted you're here. If you're a brand new listener, welcome. If you're a loyal listener, welcome back. We hope that you guys enjoy our podcast as it helps you build your practice and stay connected to the things that matter to you most. So today on our podcast we have some very special guests who've been with us. 1, 2, 3. Maybe this is both their fourth time at this point together.

[Maureen Warbach]

Frequent flyers.

[Laura]

Swipe your card for the rewards. Not sure what the program is yet, but we'll figure that out. Anyways, yes, they actually I think this is their fourth time, but they're here together for the first time today. But before I introduce them and introduce our topic today, we hope you joined us last week as we spoke with Iris Torres, talking about building trust in therapy strategies for working with the Hispanic community. If you work with the Hispanic community or you want to, this is a really great, important podcast to listen to. So check that out. So who are our guests today? Our very special guest. Well, maybe I'll introduce the topic and then I'll introduce them. So we're talking about how to build a neurodivergent affirming private practice. So if you guessed, one of our guests is Patrick Sal, you are correct. So Patrick is the founder of All Things Private Practice and host of All Things Private Practice podcast as well as co host of Divergent Conversations podcast, which I definitely recommend you listen to. I not only laughed, but gained a lot of clarity and kept saying, yes, yes, I get that. Oh my God, that's so relatable. As well as he is a retreat host, group practice owner, neurodivergent entrepreneur, coach, keynote speaker. And Patrick lives in Asheville, North Carolina with his wife Arielle and their two dogs, Hudson, Hudson and Hazel. And our other guest today is none other than Maureen Warbach, who was just visiting in Miami and we missed her again. She was down here before and we missed her. And I was in Tampa, so I missed her. We were trying to play pickleball together. That did not happen. It will happen next time. So Maureen is a visionary entrepreneur in the mental health field. As the owner of a multi location group practice and a business consultant, her goal is to help group practice owners build a practice they're proud of. And I'm excited because we had Maureen on the podcast before talking about her book, which it's almost getting to be released. So I'm excited about that. So we'll connect all of their podcasts into this podcast, but let's focus on today's topic. But before we do that, let's just take a quick moment for our sponsor. Trying to navigate all the things as a therapist is hard, especially when you're trying to stay focused on the most important thing. Your clients. Of course. That's why Therapy Notes makes billing, scheduling, note taking and telehealth incredibly easy. Also, for all you prescribers out there, TherapyNotes is proudly offering e prescribed services. One of the things that I love about Therapy Notes is that they really have the clinician in mind. Working with A company like TherapyNotes helps streamline the back end of your business. If you're a busy therapist, good quality support is essential. That's why TherapyNotes has telephone support seven days a week. No wonder why they're the number one top rated EHR and why more than a hundred thousand therapists trust them. Therapy Notes is offering two months of their EHR absolutely free, no strings attached. So go to therapynotes.com and enter the code PPS. That's therapynotes.com and enter the Code PPS.

[Patrick Sal]

Hello.

[Laura]

Hello. Hi. Hi.

[Maureen Warbach]

Welcome back.

[Unknown]

God, I hate bios much.

[Laura]

Is that why you made them shorter? You're just like N1 sentence?

[Unknown]

Well, your form asks for four sentences. Like I was trying to adhere to the form.

[Laura]

Two to four statements. You are correct.

[Patrick Sal]

I know. I try to keep mine short too. I had to cut mine. Cut mine down to the. What was it? Two to four sentences.

[Laura]

Awesome. So where should we begin on this topic?

[Unknown]

Well, I think we should begin with the fact that I don't know when this topic is going to air, but today is April 10th. We are firmly in the month of autism acceptance month. I think it's an important thing to just notate that as we're talking about neurodivergent affirming practices. I don't want to take over and diverge too much. But as an autistic ADHD person. This topics near and dear to my heart and it's really becoming a big portion of the stuff I'm speaking about in my businesses. And I know Maureen is doing a lot of the same stuff too.

[Laura]

Yeah. And you were just in Norway speaking on this topic.

[Unknown]

I was. It was super sunny and warm and negative 25 degrees every day and pitch black by 3pm it was beautiful.

[Patrick Sal]

Wow. But you saw the northern lights, so you can't.

[Maureen Warbach]

How epic.

[Unknown]

Yep. Can't see it.

[Laura]

Yep.

[Unknown]

Yeah. So where to start? Where do y'all want to start?

[Laura]

Well, I mean, kind of maybe give us some like an outline of what does that mean to build a neurodivergent affirming practice. What would that look like?

[Unknown]

Yeah. So this is typically a, an autistic process where I'm going to like get into this feedback loop where I'm looking at each one of you to see when I should talk so Maureen and I can juggle this. I don't have a good way to do this with four people, but I just did a webinar on this with Spruce Health a couple weeks ago and it's just amazing to me how much there's still that's unknown within the mental health community. So I think starting with like the fact that language is important as we start to see a lot of providers who are saying I want to specialize in working with a neurodivergent population, I want to specialize in ABC language matters. That's first and foremost and I want to emphasize that we can talk about that today. I also think it's important that your policies, your procedures, from your intake process to your phone consultation to your first appointment really need to be neurodivergent affirming. And I can talk about that stuff too. But Maureen, happy for you to jump in and share your thoughts.

[Patrick Sal]

Yeah, I'm excited to chat about this and where you're starting to talk about it from the client facing space where I've really been focusing a lot is from the business owner space with employees and like looking at our internal policies and procedures and you know, where maybe the like historic kind of assumed policies and procedures that a lot of group practices have, how non neuro affirming they are and like, you know, looking at how can we make sure that we're looking not only obviously I myself am autistic and ADHD and you know, just looking at how are these policies even beneficial or helpful to me as a person and then translating that out and outward to like everyone in My practice, who may have maybe, you know, neurodivergent, and I just don't even know about it. Like, how do we make sure that we're creating a space that like, lets them thrive in the way that they need to thrive? And what are, what policies do we have in place that might be hindering that? And then how do we open to your point, Patrick, how do we open up those conversations and like, start with communicating on just this topic within our practice?

[Laura]

Yeah, tell us a little bit more. Like, give us. We'll just take the policies and procedures. Give us an example.

[Patrick Sal]

So I guess one big thing that we do that wasn't something that we did ever until, you know, maybe two years ago was during our onboarding. We one highlight like our identities and obviously to the point of comfortability for everyone, but we model it. We have these like cards that we share with everyone that gets hired sharing all of our identities. And then we talk about accommodations right away. So I obviously accommodations are, you know, legal things that we need to follow, but I feel like they're usually like this not underscored thing. It's just in like a little blip in your manual that sort of gets overlooked and not talked about. And, you know, people might not even realize that they have the ability to ask for accommodations, much less. How we're seeing it now is that we highlight that during the onboarding time of like, we have accommodations in place and we're able to set up specific accommodations for you if you ever need any. And here are some examples of reasons that people would seek accommodations and just really outline it in this very laid back, which is just our style sort of way that makes it not a big deal and safe for them to feel like, oh, I didn't realize I could even ask for an accommodation for these kind of things. And so we just start the conversation with that versus it being something that's just in the manual for them to like, you know, seek out on their own and not really understand.

[Maureen Warbach]

Can you give us some examples of the types of accommodations that you guys just give in the manual?

[Patrick Sal]

So the manual won't list any accommodations because they're so specific to like even, you know, Patrick and I both with, you know, autism and adhd, his accommodations, what he might need, accommodations wise, might look completely different than me. So they don't list out specific, at least not in my practice, just because it can be so different depending on just our own needs. What we do list is like instances where accommodations can be helpful and that if you feel like an accommodation. I'm pro accommodating for everything. You don't have to meet legal criteria of anything to get an accommodation in my practice. Uh, if there's an accommodation that will make you be, feel successful and feel like you're thriving in your workplace, I'm going to offer it, obviously within the context of ability and reason. Um, and so what we do is just say if you feel like, you know, after this conversation that an accommodation of any sort could be beneficial to you, whether it's changing, you know, changing the way we give you information. Like some of us might be better at getting an email with information about the practice where as others might be better more auditory wise and would prefer a video, whatever, things like that. That's like a simple sort of accommodation that we could offer to anyone in the business in my practice, whether they are neurodivergent or not. But we ask them to also talk with our HR person who, like, that's one of their specialties is to kind of parse apart how can we help you be successful and like what kind of accommodations specific to you would be, would be helpful and how do we put that in place?

[Maureen Warbach]

I love that.

[Laura]

Yeah, go ahead.

[Unknown]

We talk about from the interview process on with our staff as well. So like we talk about schedules, right? Like how often do we work at a job where it's like, well, your set schedule is 9 to 5 or you have to work these hours in order to be in compliance. We throw all that out the window because like for different neurotypes, we're going to have different ideal times that we're working. And for our ADHD staff, they don't want to take breaks throughout the day. They want to just go from task to task to task because the interruption in that task is going to throw them into a major loop to the point where it might be really challenging to get back on track. We don't have set hours. So if someone says, I don't sleep well, I want to start my day at 2pm and I want to work till 9pm, great. I don't care. Like, I have zero preference in that. In terms of what our staff want to do, in terms of what works best for their system, I don't start my own day before 11am feels hypocritical for me to say, I need you to be here at 9am Same thing with giving the preference of like, do you want to be a telehealth provider? Do you want to be a hybrid provider? Would you prefer an office space? Things like that when we do one on one feedback check ins. When I check in with each of my staff, I give them the option of do you want to meet, phone call, video call, with the video on or off, do you want to text? And when I tell people that people are like, what do you mean you give your clinicians feedback via text. So many of our clinicians get to this state, especially our autistic clinicians, where after seeing four or five clients a day, the ability to be verbal and communicative is not there. So if they're going to absorb information, they would much prefer that to be via text message. So we do that all the time. It even means that during interviews I'm telling my clinicians, like, as an autistic ADHD therapist, I'm very direct, I'm very blunt. I can come across a certain way. I want to be really transparent about communication. So we have a communication preferences survey that we send out to all of our staff. It's anonymous. They get to submit whatever they prefer. We try really hard to adhere to that. I think this stuff is super important because the less we can find ourselves into these boxes of like, this is how a organization needs to run, the more likely it is that we are going to support our clinician systems and our client systems too.

[Laura]

Nice. And you know, Patrick, because we know each other so well, I know that you model a lot of what you talk about and even on your retreats. So my assumption is right, even on your form for your participants, attendees, you're asking them about accommodations. But I know that you model that in your open about that in your own retreats. There's times that you have to retreat. You know, you're on information and social overload and that's just what you do. And it's. I really appreciate your modeling because it really just kind of gives permissions for others to do the same.

[Unknown]

Right.

[Laura]

And you know, when I listened to quite a few of your neurodivergent podcasts, there was a lot of like, relatability, the escape plan. I always escape plan. It's kind of like, you know, my partner and I, we used to fight about it forever, but now we take two cars. When I'm done, I'm done and I'm out. Right. Like I just can, you know, so there are just a lot of things that you talked about that are very relatable. And you know, ultimately when, you know, our staff and team is successful or we meet our clients where they're at, we're all going to have better Outcomes. Right. You know, being in leadership for so many years, you know, I love the disc profile, right. Because I want people to do the things that they're best at. Even RVA here at the private practice startup years ago, we would want her to like write copy and would take her so long and like this is not good. And she's just like, I, I just, I'm not good at it. We're like fantastic. You don't ever have to do it again. You know what I mean? And it's like to be able to give people what they need, what they want so they can excel, it's a really beautiful thing. So I appreciate what the both of you are doing.

[Unknown]

Thanks. Yeah, I think the retreat piece is important too. Like anyone that comes on our events, I always started off when we're doing like our welcome slash like intention setting. I was just saying like as a neurodivergent person, even as the retreat leader or co leader, I'm going to have to step away. I'm going to get overwhelmed, my system is going to get overwhelmed. And I've gotten significantly better at removing myself from environments where I would have white knuckled through it in the past, maybe even over relied on alcohol. To be able to exist in an environment that was way too much stimulation for me. And I'm not going to show up as my best self if I'm going to continue to force myself into situations and environments that are so taxing. So it really does give permission to the guests as well to do the same. So like I'm playing with like fidgets right now as we're sitting here. Same thing when we're in retreat. Same thing when we're doing any sort of team meeting within the group practice or with our clinicians and our clients. Like we have baskets of fidgets all over our offices. I think it's again just modeling behavior so that your clients also feel comfortable. Because I know as a client of being therapy forever, if I don't feel comfortable enough to do that, to move to like kind of rock or to do whatever I need to do to regulate my system, I'm going to not be able to be present in that therapy session. So it's just again modeling that behavior of like we can be affirming by doing little things that we don't even think about.

[Patrick Sal]

I was going to say to your point, Patrick, and you've actually helped a lot with me in this area is I tend to be like.

[Laura]

I don't.

[Patrick Sal]

Know, I don't know how you would say it, but, like, I. I keep my stuff to myself. You know, most people don't know a lot about me. They might know about, like, my skill or, like, things that I know, but not in. Not about me personally. And it wasn't. Patrick was. So I. I've been diagnosed with ADHD for a really long time, but I've had. And my eldest child is autistic. My youngest is adhd. Um, but for the past couple of years, I've. I've had this inkling that maybe I'm autistic. And when I met Patrick for the first time in person, he, While we were out, was like, oh, you know, you're so autistic. And I remember feeling like, very, like, this sense of, like, oh, my God. Really? I've been thinking it, but also having this sense of like, maybe I'm just, you know, making it up or whatever. You know, obviously I went. I got tested and whatever. But I'm realizing, to Patrick's point, I'm not a great modeler of it. Like, I. Because I am so introverted and just keep myself to me that it's been a process in my group practice to model and share, like, you know, what they might be thinking of me might change knowing that I'm autistic in adhd, and that might change their whole perspective. But it also, um, that sort of self acceptance and advocacy, self advocacy in the workplace also just trickles down to my team, who then is like, okay, I think I can feel safe saying, hey, did you know I. You know, I have ADH too, ADHD too. And, you know, these are some things I struggle with. And I didn't realize, like, there might be some accommodation that we can work towards for it. So I guess partially to your point, Patrick, but also a thank you to you for kind of kicking me in the butt in that way. And also how much it's changed how I present within my group practice.

[Unknown]

Thanks.

[Laura]

I love that you shared that story because Patrick had shared with me the first time you guys met in person.

[Patrick Sal]

Oh, yeah, you got a text. You got a text. I remember that.

[Laura]

Oh, you were sitting right there.

[Patrick Sal]

Is that what we were together? Yeah, we were talking about you. I don't know about what. And then he's like, oh, I'm friends with her. Let me text. And then, yeah, that was funny.

[Unknown]

You're the second person on a podcast this week that's been like, you told me I was autistic. Like, this is becoming a superpower that I. Because a lot of my friends are Like, I don't know if I was ready to hear that, but it is something that I think neurodivergent folks sank up really well because there's this ability to, like, let your guard down, be your weird self that you often have to mask where you don't always fit into a lot of places and it feels like a really comfortable place to be when you're like, I don't have to explain these things, these neuroses that I maybe struggle with or these issues or the social challenges or whatever. But that was the first time I had met Maureen in person, so. But to my credit, I knew immediately.

[Maureen Warbach]

As a matter of like, what an intro.

[Patrick Sal]

Yeah, well, he didn't start off like, immediately like that. He must have held that knowledge for like a good hour or two before, before it came out. Yeah, it was the alcohol, definitely. But I, I was not one of those that wasn't ready to hear it. So lucky for you, I guess it was.

[Maureen Warbach]

Well, it sounds like it was validating and freeing for you, and it's really inspired this whole transformation and how you're like, running your businesses and how you're stepping out of your comfort zone and starting to model things in a different way and inspiring others in the process. And I love hearing your different perspectives on this. And at the beginning, Patrick, you had talked about how, like with the client process, when they're coming across your materials and your marketing materials, your website, whether you're meeting with them online or in person in the office, there's. There's a lot of different things that you can put in place to make it clear that you have a neurodivergent affirming practice. So I just wanted to come back to that to see if you could speak to that a little bit more.

[Laura]

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[Unknown]

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Look at Kate trying to wrangle in these two nerve. We're just going off on these tangents.

[Maureen Warbach]

Tangents are great. I love the tangents.

[Unknown]

So yes, there are things that we can do pretty immediately. And like I mentioned, language is important, right? So if you are out there and you're like, I really want to work with autistic or ADHD people or neurodivergent people, because the neurodivergent virgin umbrella is larger than autism. Adhd, I want to name that too, because a lot of conditions get overlooked. But I think language matters. And to Maureen's point, like when we're talking about comfortably and safely identifying a certain way, I am a firm believer that relatability equates to accessibility. And I think that starts with just reading about me or a bio or a webpage. And I encourage all of my clinicians to, if they feel safe enough to do so, to do the same thing. Like because clients want to know that you get it, right? Especially clients that are members of marginalized communities. They don't want to come in and have to like hold back a part of themselves. They want to just safely say, I can explain the situation and maybe you get it and maybe the situation isn't identical. But you're going to understand it without having to like, go into detail about abc. I think that is so validating. And so language, for example, the autism movement especially is really moving into this identity first movement with the usage of language. So that would be like, when I introduce myself, I'll say, I'm an autistic entrepreneur, I'm an autistic therapist. I'm an autistic human being. Not, I am a human with autism. Not, I am an adult who is autistic. And definitely not using asd, autism spectrum disorder, stuff like that. High versus low functioning autism. Those are the things we're trying to get away from. And the reason for that is because autism is an identity, it impacts holistically the entirety of my being. I don't get to pick and choose when I am autistic. Like, I don't get to just take it off and put it out the door for a work meeting or a social gathering or an interpersonal or a relationship. Like, and it impacts your sensory system, your nervous system, your neurodevelopment. Like, it impacts everything. And it's a lifelong condition and neurotype, which is why it's so important to move into this place where we are using this affirming perspective. So language first and foremost, again, important, then tiered off of that, I would say, like, similarly to what we do with our clinicians is what we should be doing with our clients. That means, do you want to meet virtually? Would you prefer to fill out your intake paperwork with me on the screen? Like, in a body doubling sense? Because it might just be really challenging to your executive functioning to like, figure out the steps without some guidance. Would you prefer to meet via text message or phone call? A lot of clinicians are going to cringe at that statement of like, how can we do that? Setting up your office appropriately so that it's really low lighting so you're not using like scented candles and smells. And you might ask yourself why. But so many of us have heightened sensory systems that the littlest smell can really create this environment that is unpleasant to be in both emotionally and physically comfortable seating. I always ask my clients, like, do you want to sit on the floor? Do you want to sit on the couch? Where would you like to be? How would you like to position yourself? Do you want to move during session? So many autistic people need to move. They need to stem, they need to rock. That's important for them to actually be present. The permission to not make eye contact is something we talk about constantly. I don't make a lot of eye contact. If I am, I'm feeling like it's forced, it's uncomfortable. It's kind of hell, honestly. So giving your clients permission to look around the room or the zoom screen or turn the camera off. There are so many little ways to make sure that we set ourselves up and our practices up for success. And I think when we struggle with these concepts, it's because it's like, well, this is how it's supposed to be done. And that doesn't work for the neurodivergent person.

[Patrick Sal]

Maureen, go ahead. No, I was about to say everything that you're talking about literally goes against like, the systems that are in place when we think of being a therapist and what we're taught. So I just, I guess, want to share an understanding for those that when they are listening to this are like, oh my, oh my God, this would be. I would have to tear apart everything I'm doing because I have everything so systematized. Everyone has to fill out this form and it needs to be submitted 48 hours beforehand. Like, and I'm actually, in a weird way, like, very rulesy in that way. Like, I like to have everything organized. I want things to happen at a certain time. I want to know the paperwork. And so even for myself as someone who is neurodivergent, it's been eye opening to, to realize how my, who I am and how I present, like, can be at odds with like, how someone else with a different neurotype would present or need, like, information. Because I have some rigidity around like, things being in a certain order happening at a certain time and like, knowing everything is very similar so there's nothing's going to fall through the cracks. And so you saying this, I, I feel like it's a, a great reminder for people of any neurotype to, to realize that what we've been taught to like, have things be structured in a certain way. Just because it is that way doesn't mean that it needs to stay that way.

[Unknown]

Yeah.

[Laura]

So how, how does it work when, like, for you, that's not really how you like, say texting, say you don't like texting. Right. But someone prefers texting. And it's really hard for you, like, how, how do you balance all of that?

[Unknown]

Constant communication, I think is crucial, like to kind of do check ins both with your client or clinician or staff member, whoever, and to also be really honest about your own preferences and needs too. I think that there has to be a balance and a lot of clinicians will struggle with like the whole like, well, I wouldn't mail my clients their intake forms because they would prefer to write it out instead of type it, or I wouldn't body double with them on a video screen. I think about how often clients fall through the cracks because they don't fill out their intake paperwork. And if I, if jumping on a zoom call for 10 to 15 minutes allows them to complete it right, that's an accommodation I'm willing to make. Similarly with texting, similarly with meeting with the video screen off, et cetera, et cetera. And I think that stuff is important. And if we're looking at autism, adhd, especially as disabling conditions, which they are, then if we're holding people to these unrealistic neurotypical standards of like how they have to show up in society, we're going to let them down every single time. And that goes into cancellation policies, late cancel policies, et cetera. And I'm not saying not to enforce them. You should get paid for your time. But there are little things you can do to make your policies more neurodivergent affirming, like agreeing to attend a 15 minute check in text with someone who's ADHD who might have just lost track of time because they are so consumed in whatever they're doing that all of a sudden that appointment has overlapped with something else for an autistic client who might have a significant special interest and they're super hyper focused on something, it's really easy for that to happen. So going over these policies with your clients and saying like, how can we create little accommodations, tweaks and edits to ensure that we are providing the most affirming care imaginable. And I think it doesn't take that much effort to do this stuff. It's just again, like to Maureen's point, thinking about it from a completely different perspective and I was going to diverge into high versus low functioning labels, but I don't think, I don't know. That doesn't really necessarily matter. But I think again, just coming back to the point of like, I think there are lots of little tweaks that you can make to your practice to really ensure that you're supporting clients to the best of their, their.

[Maureen Warbach]

Yeah, it's super helpful to hear your different perspectives. And it really gets me thinking as a group practice owner about how I can do things differently and how I can be more affirmative and attractive and accommodating within reason, you know, everything within balance. But it's bringing A lot of things to mind that I'd like to update and how we do things. Yeah. So thank you.

[Patrick Sal]

Yeah, I feel like that's something I'm doing all the time. And my anti racism coach, Natalie Edmond, years ago said to me when I was in the beginning of my like, intentional anti racism journey, she had said, there's like, not an end. I'm saying this because it translates across to what we're talking about here. But there's never like a point where you can check off and be like, I have a completely neurodivergent affirming practice or my practice is anti oppressive completely. So I guess just to your point of. It's just I do a thing of just every six months I look at my manual and I have a leadership meeting where we're. Let's refocus all of our efforts back onto this. Have we learned anything in the past six months that like, we need to apply to our operations or employee manual that like, we just didn't have the knowledge or awareness of six months ago? And that's just the way I we. Because I have a lot of perfectionism and wanting to just have everything right the first time around of working around that is like remembering what Natalie said of it, that never does end. You're never going to be able to check that off of your list of being set and good in that way. And so I just have something in my calendar every six months to remind myself to, you know, have this intentional meeting to see is there anything else we can do, you know, to add now into our policies or procedures.

[Maureen Warbach]

Yeah, Constantly evolving.

[Patrick Sal]

Yeah.

[Laura]

I swear we could talk like another like 30 minutes on this, but we appreciate the both of you being here and showing up as you are and you know, role modeling and sharing and identifying and sharing, both from the group perspective, the, the group practice perspective, but as well as what we can do for our own practices and help clients. So we appreciate the both of you. It's always great to see you. What do you. Each morning you can go first want, you know, our audience to take away from your message today.

[Patrick Sal]

I, I guess that like, what's been most impactful for me is, is the ability to feel comfortable self advocating as a leader and seeing how much of a positive impact that's had on just the people around me. That would be mine.

[Unknown]

Awesome.

[Laura]

Thanks, Patrick.

[Unknown]

I would say to just listen to autistic and ADHD voices, content creators, authors, podcast hosts, therapists, people who are telling you like, this is what we need, this is how we feel seen. I think it's super important to incorporate and just to pay attention to. There are not enough neurodivergent therapists out there, so there are going to be instances where neurotypical people are going to have to support neurodivergent clients. So the best learning does come from that type of experience, for sure.

[Laura]

And I definitely want to shout out your podcast again. I learned a lot. And like, I, I think I was waiting to pick up someone from the airport as I was in the little car waiting area and I like, you were just talking. I was like, oh my God, yes, yes, I can relate. Yes, I can relate to that. I was like, whoa, this is interesting, right? And things that I just don't think that, you know, a lot of times people think of. So that was really helpful and you get just to listen in on conversations about, you know, this topic. So thank you, gu, both so much for being here. We're going to put all your podcasts into the show notes and we just really appreciate it.

[Unknown]

Thanks.

[Patrick Sal]

Thanks for having us.

[Maureen Warbach]

Yeah, absolutely. Startup Nation. We hope you enjoyed today's episode. It was really informative and inspiring and I, Katie and I always love hearing from you and we've done so many podcast episodes, 357 at this point. And we're always trying to create content that really meets your needs along the practice building and growing journey. So there's a topic that we have not had on yet that you would love to speak on and, you know, let us know. So we want to encourage you to subscribe, rate and review the show and.

[Unknown]

Share with your friends and fellow colleagues.

[Maureen Warbach]

Who could really benefit from this particular episode and we will see you next time. In the meantime, stay inspired.

[Laura]

Take care everybody.

[Maureen Warbach]

Thanks for joining us on the Private Practice Startup. Visit the private practice startup.com for awesome resources, free trainings, attorney approved private practice paperwork, and so much more.