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Nine Signs You are a Normal Therapist . . . and encouragement to break the mold.

Image: villagehat.com

Image: villagehat.com

In the BBC hit series, Sherlock, the protagonist, Mr. Sherlock Holmes, characteristically known by his unusual double-billed hat called a “deerstalker,” given to him by his faithful Dr. Watson, describes himself as a “consulting detective.” Further, he also describes his nemesis, James Moriarty, in similar fashion, as a “consulting criminal.” This description, of an external expert as consultant, is something we need. In the profession of mental health, we need more “consulting experts” and fewer “normal therapists.” Consulting experts . . . ready to use their knowledge and skills to assist in all kinds of venues. Medical, legal, business, government, education. Here’s why.

I’ve been a professional therapist for over 35 years. I don’t consider my journey within the profession to be that remarkable or different from the “average” or “normal” therapist. Where it has been different, has been in the things I have done outside the “normal” parameters. In working with manufacturing companies, with family-businesses, non-profit organizations, and others.

Being a “normal therapist” myself, I’ve also supervised, administered, trained, and taught hundreds of other normal therapists over the years, and . . .

Let me be blunt . . . there are a lot of things about being “normal” that, over time, will drastically increase the risk—the risk of practicing in a manner that will undermine the therapist’s life and career. Over time, doing significant damage if not understood, addressed, and overcome.

What do I mean? Well, let me tell you. I mean that I have cringed as I have heard too many therapists, often nearing the end of their careers, that don’t have good retirement savings, do not take off quality time from their practices (some skip vacations and have not had a quality vacations for years), are not in a position to financially help their children or families and who are burned out, tired, and, sometimes, defeated by the very career they chose to support and sustain them and their families.

From a business/career stand point, the normal therapist is often their own worst problem. Let me lay it out for you . . .

Nine signs of the normal therapist:

  • Believes that working for an organization is safer than working for themselves. Ah the benefits! Salary, insurance, paid time off, training budget . . . there are several aspects of working for an organization that appear to make it the safe choice. But is it? It feels like it until the the layoffs, down-sizing, closings happen. Most businesses, even Fortune 500 firms, don’t last more than about a couple generations. It’s just not as safe as you think.

  • Thinks that the most reliable way to get paid is to be dependent upon insurance reimbursements. I hear many talking about wanting to get away from insurance but most, even the experienced, see insurance as a reliable source of revenue. Okay, sure, it is. But, organizations—who provide coverage for your clients— change insurance providers. Reimbursement rates are dropped. Getting paneled becomes more limited. You either spend time chasing the payments or pay someone to chase them for you. Is this really the most reliable form of income? For me, the answer is, “No!” Contracts, several that have laster more tan 12 years in my case are far more reliable. Negotiated rates with organizations that appreciate the value you offer is far different than the insurance panels trying to minimize costs.

  • Worries that peers, or others, may think they are driven by a desire for money. Occasionally I wonder if the worst thing you could say to a “helping professional” is that they seem to be “interested in being financially successful.” Most deny this by quickly pointing to other priorities for their work. But, just because it is not their primary goal, does it mean that they don’t want to be financially successful. In most cases, “No.” However, they are uncomfortable acknowledging this. They constantly make sure that peers know, and will not judge them, by downplaying and insisting their focus is not on money.

  • Are willing to trade time for vague benefits. They are wooed by vague benefits to their own career and live based on hopes reaping “marketing benefits,” unplanned “giving back” to the community or profession, and “just a good experience. They accepting being on call, providing free phone support, writing letters, and other tasks without much, if any, benefit to their business. I’m not suggesting that none of these things should happen—circumstance dependent, any and all of these may be appropriate or necessary; my point is, that the normal therapist simply does this, and accepts doing it, because it has been the standard practice historically.

  • Makes excuses about the unsavory elements of their career rather than working to change them. Long term complaints about hating paperwork, insurance, no shows, without taking assertive steps to remove those things from their business life. Most will simply accept these things as part of the profession rather than re-examining their utility in today’s environment or seek other forms of practice that minimize or eliminate some of these elements.

  • Constantly seeks to reassure themselves that they are competent. I hate to say it, but a majority of normal therapists have a lot of self-doubt. Just like the college student taking Psych 101 and wondering if the symptoms described in class men that they have a certain diagnosis, therapists, perhaps due to the personal intensity of their studies or primal interest, often give marquee attention to their weaknesses or deficits rather than their strengths. Few feel confident that they “know enough” or are an “expert” beyond a narrow and specifically trained knowledge base and skill-set. Yet, in truth, their life-experiences, knowledge, and training make their utility much more broad then they imagine.

  • Doesn’t take risks, even small ones, that could provide significant improvements in their career. You’ve probably heard the old joke, “How many therapists does it take to change a light bulb?*” How about the correlary, “How many therapists . . . will change.” Therapists tend to play it safe. Leaps of faith for the sake of their career are rare. This includes wisely spending money to increase the likelihood of progressing in their careers. So, they go to mediocre trainings, don’t pay for supervision to gain expertise, do not spend money to learn new processes or products that could make their practice stand out and separate them from other providers.

  • Follows the rules. While their are pioneers in our field, out there breaking new ground, as a group, therapists are prone to follow the “tried and true” of that the profession has dictated health care “is.” There are few “disrupters” or “contrarians” as a rule in the group and thus not much innovation. Tendencies run more toward “am I doing it right?” and against, “could it be done better?”

  • Feels victimized by outside sources. Let’s face it colleagues. We often “play the victim.” Whether it is society, insurance companies, culture, history, etc. there is often a stain of helplessness norms in our thinking. These professionals, among the highest educated and trained people in the world, feel trapped and powerless by forces outside their control. We may seek to liberate others from the forces that we fear may be in fact constricting our own trajectory.

Professionals that stay trapped in this normative mindset may have an adequate, or even good, careers. Many do. They will, however, be subject to operating within the confines of the health care system and their own perceived limitation of their profession. The tragedy of this is that their are no “consulting therapists” in daycare centers, oncology offices, pediatrician practices, legal firms, or on family business boards—among many other places where they could provide significant benefits. More sadly, most professionals have never even asked themselves the question, “Could they benefit from my consulting?” Thus, the inquiry is never made. No discussions take place. No services are defined or contracts completed . . . and no help is available.

Do you see these signs in our profession? How does it affect the careers of your colleagues? How many of the nine traits influence your thinking?

As a profession, we need to focus on becoming more entreprenurial, taking a broad view of our capabilities, and turning those into non-traditional areas that could use our help. IN as sense, we need to see our selves as “consulting professionals” and not just therapists. Are you ready? If so, grab your “deerstalker” and let’s go. The game is afoot, dear Watson.

Ready to be abnormal? Share our post, make a comment, or more than one, and include in your comments how you shared the post, and you will be entered in a drawing for a digital copy of our book Beyond the Couch: Turning your behavioral health degree into cash without losing your soul and other prizes. To encourage comments, we will give away one copy of the book for every 10 comments. So, even if you already have it, or are not interested in the book for yourself, you can tell us who you’d like to give to or we will give it away for you!

*So, how many therapists does it take to change a light build? “Only one, but the light bulb has to want to change.”

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If you practice like no one else, your practice can be like no one else!

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Some of our giveaways I got to share with my colleague at coffee. (Graphic Design by Andrew Miller (andhegames.com and andhedrew.com)

If you practice like everyone else, your practice will be like everyone else!

Throughout my almost 30 years working in the health care field I have had great colleagues. These experts provide critical services for individuals, couples, and families. They are specialists—true experts—in their scope of practice and I happily refer to, collaborate with, and respect them for their work.

However . . .

Considering the “State of the Art”

Colleagues in our field as a group, perhaps like most industries, generally talk, month in and month out, about the same repetitive topics . . . referrals, going “fee only” (or dumping insurance), recruiting new professionals, insurance contracts, and procedures or techniques they are learning or implementing. Go to coffee with many in the behavioral health industry and you are sure to wind up talking about these issues.

There’s nothing, at all, wrong with that of course.. These are the daily concerns of the typical practice and the variables that owners/providers need to focus on to be successful. Many are happy to confine their “work life” to these issues but some of us are not.

For the “others” these topics, while necessary to deal with, are often redundant, task-focused, conversations that—like chores—need to be done but rarely result in a “bounce in the step” after the conversation. After almost three decades in the industry, while these continue to be necessary discussions, engaged in regularly, I find myself more interested in conversations about the national melodrama of politics, the latest cool product (currently Darn Tough socks), new technologies, or woodworking projects. Maybe you can relate?

A different practice

I was reflecting on this after a recent coffee meeting with a colleague. No, not because the conversation was a better version of the typical topics, quite the opposite, because it wasn’t—at least not the vast majority of the meeting. A meeting that I left feeling energized, excited, and ready to push my business forward. Why? What was different? What was different is we weren’t just talking about the same-ole-same-ole topics.

My colleage isn’t just practicing like everyone else. He is more entrepreneurial that the average clinician.

Through serendipity and the encouragement of others less risk-aversive, I have learned, despite my natural tendencies toward the opposite, to do the same. So our conversation wasn’t about insurance, referrals, recruitment and all the old repetitive topics. Instead, the conversation was about an upcoming training we are doing out of state, demonstrating for him a game we newly licensed to use in our training, possible opportunities with a local manufacturing enterprise, and discussions about developing our own new software games for training. All factors of my practice not being defined by the typical “private practice” label.

Sustained changes

This week, under this broader umbrella of Human Systems Consulting, we will be billing an engineering firm for coaching. Signing a training contract with a government agency to use games to train leaders on teamwork skills. Continuing our monthly trainings of other professionals on becoming consultants. Talking to a non-profit about the status of a 13 year old contract to determine if it will continue as is, change, or be terminated. Continue discussions about developing a communications/teamwork game with a software developer. None of this directly related to my full time private practice as a mental health professional.

If it sounds like work, it is. Is it But its work, I find, that invigorates. It’s not boring. It’s new. It’s mine. No one else, outside my team is doing what we are doing. It continually challenges me to grow and expand my learning, my skills, and, assumably, my value to systems who need some help. It also protects from some of the inherent risks in healthcare. All factors that makes the private practice less anxious, more sustainable, flexible, and versatile.

Normative vs. transformative

Now, if you tend toward the stable, comfortable, personality that enjoys routing, likes tweaking and improving know systems, and are perfectly happy with continued discussions listed in the first scenario—then good for you! You likely are not looking for something different or more. However, those who crave learning new things, challenging themselves to do more, want new vistas or horizons to explore . . . even if you are good at putting up with the first scenario . . . then this latter scenario is much more invigorating. In my experience, it is an antidote to burnout and makes you more enthused about both.

What would you like your practice to look like if you could choose to do whatever you wanted?

What services or products would you be excited to provide?

What’s stopping you?

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Entrepreneurial Farming

Putting up the hoop house or high tunnel for Old Depot Farm. My role now? Loading up the produce every Tuesday morning.

Putting up the hoop house or high tunnel for Old Depot Farm. My role now? Loading up the produce every Tuesday morning.

Risk and Opportunity

I often talk to professionals in the mental and behavioral health field and I repeatedly walk away with the sense that most people who go into this career are not risk takers. The idea of doing free-lance, contract, or entrepreneurial projects is a strange and scary--but somehow exciting--prospect.  I understand. I am not naturally a risk taker myself.  But . . .

Time and necessity make us grow and face realities . . . and this has led me into becoming more entrepreneurial and willing to get outside the box.

My wife needs no such prompting. She is more comfortable with business in general and specifically with engaging in the "to and fro" of dealing with the vagarities of an out of the box process. As such, she and a few other farmers, have developed Tiny Farm Group, and together provide local produce and edible flowers to local chefs.

One restaurant, Venue, with its dynamic staff, led by Chef John Benton, recently brought some of the chefs to visit our farm and created a video featuring Amy.  Her business, Old Depot Farm, features all the elements of business we promote at HSC -- collaboration, high quality, people-centered, service -- and has contributed to making Tiny Farms Group and the partnership with Venue a powerful joint venture.

This leads me to talk about other ventures we have started and run . . . without any degrees or training . . .

Melodrama

Since 2002, we have been directing and producing an annual melodrama for area home-school youth. This project consumes much of our extra time from November through February. Roughly 12-30 students annually participate and many have gone on to get theatre scholarships or even degrees after being part of our melodrama group. We couldn’t do it with out our army of willing parents and others but it has provided a lot of positive friendships, skill development, and one wedding.

Plant Sale

Amy has run an annual plant sale from our acreage. People come from more than two-hours away to purchase her select varieties of tomatoes, peppers, basil, etc. and to connect with the Old Depot Farm’s proprietor. We’ve had musician’s play, grandma’s famous doughnuts—while they last, which is typically only minutes—given farm tours, and connected with our local farming geeks.

It continues to amaze me how many “out of the box” things people are willing to support. As a friend, and local dentist, who admittedly provides “cadillac care”, says “people will pay for what they value.” I do. Why am I surprised that other will as well? “If you build it, they will come.,” is a more true adage than my risk-avoidant personality thought possible.

P.S. -- If you want to learn more about Amy, Old Depot Farm, the Tiny Farm Group, or just read great posts on local foods, or if you just enjoy a good laugh and really good writing, check out her blog.

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Unintended Contracting

Since 1994, I have had all or some of my professional work paid for through contracts. This was NOT the plan!  I have mentioned before in this blog that I am not, by nature, an entreprenuer. To wit . . .

  • I hate the idea of sales and marketing.
  • I am not a "joiner." Involvement is not something I seek.
  • I am inherently risk-aversive.

Thus, my first contracts came by "default." That is, through no intention or effort on my part to try and sell my services. Here's how it happened . . .

1993: A colleague offered to guarantee 3 months pay to encourage me to join their private practice. The hospital, whose employ I was leaving, offered to contract with me, part time, for weekend therapy groups.

1994: Citibank, who had bought the hospital chain, closed the hospital. An education consultant, who had a contract with the Department of Education, offered me a contract to do counseling with identified kids in schools. (Realizing this part-time gig paid me better than the full-time job was an eye-opener. But, I had dreams and it was off to grad school.)

1997: A colleague of mine and I dreamed up a consulting gig as part of an assignment for a Qualitative Research class. We proposed, with support from our professors, to help improve employee satisfaction at this 3,000+ plant.

2000: A university offers me a job, but it's not where I want to live. I counter-offer to teach from my preferred location. This leads to a contract to combine trips to campus and distance-learning that continues for 15 years until I decide to retire to pursue other interests.

2003: Interest peaks among students about the consulting work I am doing and I am assigned to teach a Doctoral class on Consulting with Larger Systems.

2010: Students continue to value the class and encourage the writing of Beyond the Couch. As multiple students indicate that the class has been the "most practical" and "best class" in their curriculum, I begin to dream about how to help others benefit from contracting.

2011: I begin coaching mentees about developing contracts. These colleagues develop contracts with schools, churches, medical practices, and non-profits. Personally, I continue with my work with a limited private practice and consulting.

So, that's it.  Let me encourage you to seek colleagues, opportunities, and supports to add contracting and consulting to your "toolkit." It will open up many doors to creative and energizing work!

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Promotion . . . and savings!

Screen shot of the first campaign after a week.

Screen shot of the first campaign after a week.

Have you discovered Outbrain?  This service is a way to market your products and services to consumers on line. It allows you to easily create ads, target specific geographical markets, and set your budget so that you can plan your expenses as you grow your business.

HSC is testing a marketing campaign on Outbrain currently. What we are finding is that it quickly creates a large number of "impressions"--presentations of your ads--in your geographical areas very quickly. It has increased traffic to our website, created new subscribers to our email list, and produces a few sales. Not bad for a campaign running only a little more than a week and costing less than $40.

We continue to experiment with our promotion. One thing we have done is to temporarily lower our prices--to put our products on sale at Gumroad. While this places them as "loss leaders" (in other words the prices won't support the cost of providing them-marketing costs, software product costs, etc.) it will help us gage the marketability of the products themselves.

So if you have some products or services you want to sell. Check out Outbrain! It presents a very low bar to "test the water" and dip your toes into on-line ads and marketing.

Special thanks to everyone who continues to tell others about us! We are energized by your support, your comments, and your sharing!

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"Five for Five" or "Old Dog Rebellion!"

Here is some of what I'm working on . . . soooooo slowly!

Okay, I'm an old dog.  I remember the 60's . . . although barely. Now I'm part of the group disparaged by that oft-repeated adage, "You can't teach an old dog new tricks." Fortunately, I come from stock that didn't listen to such dour predictions. Both my mother and my father were still engaged and working into their 80's. So, to carry on that tradition . . . I thought it would be fun to share "5 new things I've learned in the past 5 years" and to hear what others have learned in the past few years as well.

In the past five years I have learned . . . 

1. to read music (and improve my fingerstyle guitar playing)

2. to drive on the left side of the road (thank you New Zealand!)

3. the proper way to make face-frames for cabinets

4. to use apps, like Trello, to deliver consulting services

5. what Kombucha is and how to spell it

There's my list. Obviously not all of these things happened in one-year's time so things like "reading music" could still be on my list next year but I'm hoping to add five new items for 2017.

Come on, the rest of you "old dogs," what did you learn in the past five years?

Available eBooks:

Private Practice through Contracting: Decreasing dependence on insurance.

Engaging Your Team: A framework for managing difficult people.

Family Legacy: Protecting family in family business.

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What is an Organizational Behavioral Consultant?

Organizational Behavioral Consultant.  It's a mouthful isn't it?  What exactly does it mean?  Well, I'll give you my take.  First, Organizational to me means "system."  In other words and Organizational Behavioral Consultant (OBC) should have a focus on the organization as a wholistic richly cross-joined system.  He or she needs to understand the entire "animal" and how subsystems work within the larger needs of the organization.  They need to understand that each subsystem is interdependent upon the others and a change in one will effect the other subsystems.

Second, Behavioral means that the focus is on how the organizations actually "acts"--what it believes, says, and does. No grand theoretical models here!  Instead it is a practical, pragmatic, approach that focuses on real outcomes and solutions.

Third, consultant.  For me this means a collaborative partnership.  Working with the talented, smart, experienced leadership in a way that allows our "outside" perspective and experiences with the methods, processes, and tools of consulting to help influence and guide the steps to creating the most effective and successful system.

Well, that's it, I've run out of words to define.  Organizational. Behavioral. Consultant. Do you see it differently? Would you change or alter the definition? Share it. Maybe I'll change mine as I continue to upgrade and grow in my own experiential path. Thank you, as always, for sharing!

Available eBooks:

Private Practice through Contracting: Decreasing dependence on insurance.

Engaging Your Team: A framework for managing difficult people.

Family Legacy: Protecting family in family business.

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