Episode Overview
Podcast: Private Practice Startup
Episode: 96 – Building a Group Online Counseling Practice
Air Date: July 28, 2018
Hosts: Dr. Kate Campbell & Katie Lemieux
Guest: Dr. Lisa Herman, Founder of Synergy eTherapy
This episode explores the formation, growth, and operation of Synergy eTherapy, a 100% online group counseling practice. Dr. Lisa Herman shares her journey from solo online therapist to building a thriving, multi-state group practice. The discussion covers recruitment, technology, legal/ethical considerations, culture-building in virtual settings, and marketing for online therapy.
Key Discussion Points & Insights
1. Dr. Lisa Herman’s Transition to Online Practice
(05:30–08:17)
- Lisa started her therapy career in traditional, "brick and mortar" settings in NY and MN.
- Sought ways to serve her New York clients after relocating to Minnesota, sparking her entry into online therapy about six years prior.
- Built a solo online practice serving multiple states, then transitioned to a group model when a colleague expressed interest in joining her.
- Growth: Quickly expanded to six therapists across three states (MN, NY, SC); ongoing interviews for expansion.
Quote:
_"I just kind of jumped. I just was learning a little bit along the way, and I jumped in and I was doing that for about five years... In the past year and a half, it really is just grown. People are eating it up, both on the therapist side and even on the client side." – Dr. Lisa Herman (07:16)**
2. Recruitment, Team Building, & Company Culture
(08:18–12:35)
- Recruitment: Lisa receives resumes via their website and Facebook groups; free consults screen candidates.
- Values Fit: Looks for clinicians she’d trust with her own family; emphasizes down-to-earth, relatable, and experienced practitioners.
- Culture: Despite being remote, emphasizes connection, mentorship, team effort, and support. Monthly consult groups and collaborative marketing foster a sense of community.
- Vet-out Criteria: Readiness to invest time and money, willingness to build from the ground up, and ability to collaborate.
Quote:
_"I want to refer my family member, my husband...to whoever is working for me." – Dr. Lisa Herman (09:27)**
3. Business Structure & Financial Model
(12:35–15:10, 21:09–23:54, 27:22–28:59)
- Financial Setup: Therapists pay a modest monthly reimbursement and revenue split (starts at 80/20 – therapists keep 80%).
- Support Provided: Lisa organizes legal/ethical documentation, technology, and marketing materials; therapists receive set-up, IT, and ongoing mentoring as part of their fee.
- Employment Status: Each therapist functions independently under the Synergy eTherapy umbrella. Revenue flows directly to therapists, and they pay for centralized resources (accountant determined 1099s not required under their structure).
- Affordable Launch: Lisa’s approach reduces start-up risk/cost for therapists, making group online practice accessible.
Quote:
_"For the, you know, 100 and a quarter or whatever it is that they're paying a month, that's nothing to have a private practice... I want it to be affordable for people. I want them to feel comfortable." – Dr. Lisa Herman (21:44)**
4. Legal & Ethical Best Practices in Online Therapy
(13:03–15:10, 23:54–24:34)
- Even though private pay practices are not HIPAA-covered entities, Lisa operates at HIPAA standards for best practice.
- Customized informed consents and privacy policies developed and maintained with legal guidance.
- Stays up to date on state-specific telehealth regulations. Encourages ongoing professional collaboration and resource sharing within the online therapy community.
Quote:
_"We function completely as we would be [HIPAA covered entity] just because we're private pay...so much goes into it." – Dr. Lisa Herman (13:37)**
5. Marketing for an Online Practice
(15:53–18:40)
- Similar to brick-and-mortar practices: networking, presentations, webinars, speaking to local media, and event booths.
- Leverages word-of-mouth and client referrals.
- Social Media: Team members create low-key educational videos to personalize their brand.
- Team Branding: Synergy eTherapy’s visibility grows as more therapists promote under the same name.
Quote:
_"We're out there doing presentations for schools. I'm doing webinars... We have a booth at a festival or at a training conference...Really, I don't think it's that different from what you might be doing for in person. It just takes a village." – Dr. Lisa Herman (16:05, 18:27)**
6. Handling Client Concerns & The All-Online Model
(18:40–20:32)
- Synergy is exclusively online; if a client requests in-person sessions, they refer out.
- Most prospective clients understand and opt in for the flexibility/convenience.
- Offers free video consults to ease apprehensive clients into the online format.
7. Technology Stack & Tools
(20:33–23:54, 29:06–31:59)
- Video Conferencing: Doxy.me (HIPAA-compliant, free version).
- Other Tools: Custom package of email, calendar, VOIP/texting, and website features tailored for affordability and compliance.
- Website/Brand: Partnered with web developer to create scalable, therapist dashboard-integrated, professional website.
- Collaboration vs. Proprietary Advantage: Lisa is transparent, but selective about sharing her precise tech stack—it’s part of her practice's "secret sauce."
Quote:
_"I've pieced together is not as expensive, but it is a little bit of a piecemeal. So we're trading maybe the convenience of some of those bigger...all in one [solutions], financially be a lot less, so we can do a lot more with a lot less." – Dr. Lisa Herman (31:51)**
8. Advice for Aspiring Online Group Practice Owners
(32:04–33:57)
- Don’t let fear or lack of formal business background hold you back.
- Be prepared to learn, adapt, and pay for professional support.
- Seek out mentorship and collaborative communities in the online therapy world.
- Avoid "paralysis by analysis"—start with what you have, revise as you go.
Quote:
_"Don't get stuck by the fear...just dive in and see what happens...We can get kind of that paralysis by analysis if we just sit there...if we just dive in and use our resources, it can be really amazing." – Dr. Lisa Herman (33:07)**
Memorable Quotes & Moments
- On expansion: "I didn't expect it to go so well. I know that sounds terrible. You're starting something, you want to give it your all." – Dr. Lisa Herman (07:12)
- On commitment: "Anytime you're starting up a business, there's gonna be an investment. And that's a great way...to weed out people who aren't really gonna be committed." – Dr. Kate Campbell (12:35)
- On collaboration in online therapy: "It's a really great community where we're not trying to step on anyone's toes or just take over the online world. There's a lot of room for everybody to kind of join." – Dr. Lisa Herman (26:06)
Timestamps for Key Segments
- 05:30 — Lisa’s backstory and transition to online therapy
- 08:18 — Recruitment, vetting, and building the group
- 12:35 — Team commitment, investment, and group support
- 13:03 — Legal and financial structuring
- 15:53 — Marketing online therapy: strategies & local visibility
- 18:50 — Handling client requests for in-person sessions
- 20:33 — Tech, compliance, and building an affordable online toolkit
- 27:22 — Employment structure: independence vs. W2/1099
- 29:06 — Tech stack philosophy and website features
- 32:04 — Lisa’s final advice for entrepreneurs in online therapy
Additional Resources Mentioned
- Roy Huggins (Person Centered Tech) and Clay Cockrell (Online Counseling) – key thought leaders in telehealth.
- Amber Lyda’s Facebook group for online therapists: community support and learning.
- Private Practice Startup paperwork & technology-assisted counseling consent (recommended for listeners).
Takeaways
- Building an online group practice is attainable, scalable, and can offer clinicians community and clients improved access.
- Legal and ethical compliance is critical—operate at the highest standard, even if not technically required.
- Marketing an online practice isn’t fundamentally different from a brick-and-mortar practice; personal touch and team branding matter.
- Jump in, keep learning, adapt, and don’t be afraid to reach out for help.