Presented at the American Counseling Association Conference by Thriveworks. Over 100 slides on building a private practice.

1. Thriving in Private Practice
2013
Starting and Growing a Counseling Business

2. Introduction
Transition: Technician to Entrepreneur
Running a Practice is Not Mostly
About Doing Counseling

3. Is it wise for the
average counselor to
start a private practice?

4. Should I Start/Build a
Private Practice?

5. Reasons NOT to Start a Practice
I need/want money now!
I want to keep work separate
from my life
I hate business
I want to focus on being a
counselor
I don’t want to start from
scratch

6. High Paid Agency Employee
Spread the word
Speak publicly
Make the news
Publish online and off
Build a reputation
Offer specialized services
Help out
Independently Credentialed

7. The Bootstrapper’s Guide
Make a Commitment
Pay the Price
Focus
Constant Forward Motion

11. The Bootstrapper’s Guide
Reject Excuses
Build Risk Tolerance
Avoid Non-essential Partners
Track your Progress

12. Activity One

13. Risk and Counseling Business
Being an Employee is Risky Too
Failure: Necessary but not Sufficient
Betting the Ranch / Taking a Flyer
Risk Versus Reward

14. Activity Two

15. Show me the Money!
QuickTime™ and a
H.264 decompressor
are needed to see this picture.

16. Show me the Money!

17. According to salary.com, an LPC in
Cambridge, MA makes on average $39,778 a
year.

18. Show me the Money!
Insurance: $70 per 45 min. (90801, 90806,
90847)
35 x 48 x 70 = $117,600
That’s 26.25 hours a week of therapy

19. Show me the Money!
- $490 a month (5%) for marketing = $5880
yearly
$117,600 - $5880 = $111,720.00

20. Show me the Money!
BIlling is 6% (is $7,056.00)
$111,720.00 - 7,056.00 = $104,664

21. Show me the Money!
Office: $500 a mo = $6000 yr
Office Supplies = $3000 yr
Professional Dues, insurance, education = $500
yr
Other Misc. = $500 yr
Total = $10,000 yr

22. Show me the Money!
Final With Medical Billing = $94,664.00
Final without Medical Billing = $101,720.00
Both are a FAR CRY from $39,778!

23. Show me the Money!
Let’s discuss some variables!

24. Rumors about Accepting
Health Insurance
“I’ve heard I should stay away
from health insurance”
“I’ve heard that insurance
companies don’t pay well”
“I’ve heard insurance companies
are impossible to deal with”

25. Rumors about Accepting
Health Insurance
“I don’t want to be a slave
to/employee of the insurance
companies”
“I don’t want to do all the
additional documentation”
“I don’t want to be told what
clients I have to see”

26. Insurance Panels
Gives you Leverage
HMOs More Popular
Universality of HealthCare
Mental Health Parity
Panels Will Close

27. As my 8-year-old
daughter Scoutie says:
“You Have GOT to be
Kidding Me!?!”

28. Medical Billing:
The Dark Side of Counseling
Practice
The Dark Side of Counseling
Practice

29. 17 Reasons Your Insurance
Claims are Being Denied

30. 1) You waited too
long to file the claim.

31. 2) The insurance
company lost the
claim, and then the
claim expired.

32. 3) You lacked
authorization.

33. 4) The client didn’t
acquire a physician
referral.

34. 5) You provided 2
services in 1 day.

35. 6) You ran out of
authorized sessions.

36. 7) The authorization
timed out.

37. 8) The client changed
his/her insurance
plan.

38. 9) The client lost
his/her insurance
coverage.

39. 10) The client was
late to pay his/her
Cobra.

40. 11) You sent the
claim to the wrong
managing company.

41. 12) The provider isn’t
paneled with the
insurance company!

42. 13) Services were
rendered at the wrong
location.

43. 14) The client’s OON
benefits differ from
their in-network
benefits.

44. 15) The service was
already rendered.

45. 16) The client has an
out-of-state insurance
plan.

46. 17) The client has an
unmet deductible!

47. Medical Billing Takes
Effort

48. Activity Three

49. Should I Specialize?

50. OR...

51. Finding The Right
Identity for Your
Practice

52. Should I Specialize?
Populations Served
Problems Treated
Treatment Methods Used
Business Identity

53. Should I Specialize? - TIPS
Don’t Specialize in Group Therapy
Avoid Creating a Whole Health Program
Consider Demand
Stay Consistent
Be the Best in the World
Can work in a Small Town, Too.

54. Your Therapy Office
The Bar is Both
QuickTime™ and a
H.264 decompressor
High and Low!
are needed to see this picture.

56. QuickTime™ and a
H.264 decompressor
are needed to see this picture.

59. QuickTime™ and a
H.264 decompressor
are needed to see this picture.

60. Your Therapy Office
Paint the Pig

61. Your Therapy Office
Wall Art

62. Your Therapy Office
Good Lighting

63. Your Therapy Office
Music / Better
Sound Barriers

64. Your Therapy Office
A Nice Place to
Sit

65. Your Therapy Office
Something to
Read

66. Your Therapy Office
Cell Phone
Charger
WIFI

67. Your Therapy Office
Refreshments

68. Your Therapy Office
Surprise and
Delight

69. First Impression...
(it’s actually NOT your office)

70. First Impressions...
For many
companies, its the
person at the
counter.
For Counselors,
it’s their voicemail
:(

71. Making a Good Impression By
Voicemail Trim the Fat
(yes, voicemail) Smile
Provide Value
Hang up
Um, Write it out
Update Daily
Emergency
Instructions?

72. First Impressions...
Return Calls
Veto Voicemail

73. Building a Full Caseload: 40
Quick Tips

74. Ethically Improving Client
Retention

75. Ethically Improving Client
Retention
Familiarize
clients for a
suitable course of
treatment

76. “I let new clients decide how often they come in,
and I try not to influence their decision.”

77. “I think clients know how often they need to see
me.”

78. “It’s unethical to tell clients how often I think they
should see me for therapy.”

79. Ethically Improving Client
Retention
Familiarize
clients for a
suitable course of
treatment--
Again!

80. “During the first appointment, I try to convince
the clients not to come back.”

81. “The problem is that clients are ambivalent
about whether or not they want to be in
counseling.”

82. “If clients don’t continue treatment, they must
not be ready to change.”

83. Ethically Improving Client
Retention
Familiarize clients for a
suitable course of
treatment--Again! And
Again!

84. “Many clients can be finished with counseling a
5 or 6 sessions.”

85. “The clients I saw today only needed 1 session.”

86. Ethically Improving Client
Retention
Don’t adopt a strict
“disorder-model”
approach to care.

87. “We had little to talk about in therapy this week,
which tells me that we must be finished with
counseling.”

88. “When it seems we’re not making progress after a
session or two, I suggest clients take a break
from counseling.”

89. Ethically Improving Client
Retention
Break the “See You
Next Week” Mold

90. “None of my clients want to see me more than
once a week.”

91. “I’m not a psychoanalyst. I can’t see clients more
than once a week.”

92. Ethically Improving Client
Retention
Don’t terminate too
early.

93. “Really?” I said. “Did he buy a ring?”

94. “Um. No.”

95. “He proposed?”

96. “Haha, no. I didn’t think of that. Maybe we’re not
done after all.”

97. Ethically Improving Client
Retention
Follow up with Clients
who have lost touch.

98. “I’m worried that a phone call would be a
nuisance to my clients.”

99. “My clients will be ‘creeped out’ if I call them.”

100. “My client is an adult and should call me if
he/she wants to continue seeing me.”

101. Wrap Up

102. Thriveworks.com/Private-Practice
1-855-4-THRIVE