Building Your Therapy Practice

Contributed by Vicky Nguyen on January 23rd, 2019
Content: Mental Health Care in Canada

Psychotherapy Matters had the pleasure of interviewing Dr. Eric Morris about his book “A Brief Guide To Building Your Therapy Practice.”  

PM:  Tell us about yourself.  

I’m originally from the Unionville/Markham area and I did my undergraduate work at Trent University in Peterborough but I currently live in Montreal, where I did my graduate training. I’m an avid reader and I’m in the process of learning to play guitar. I’m also happily married and have three kids, a dog and two cats.

PM:  What sparked your interest in mental health and psychotherapy?  

I’ve always been fascinated in how others think. From an early age, my friends would open up to me and I loved listening to their problems and offering my help. Since I was a teenager, the only job I have ever wanted was to be a psychologist.

PM:  How did your training get you to where you are today?  

I obtained my PhD in Counselling Psychology at McGill. It was a very supportive environment that allowed me to develop an eclectic approach to therapy. In that, I was able to take the elements I found useful from the different therapeutic modalities to create an approach that suited my abilities and interests. I was also fortunate to have a diverse range of practicum and internship training, including in addictions, in a university counselling center, in high schools and in an active private clinic. Each of these experiences built my confidence and exposed me to a variety of challenging clinical cases.

PM:  Tell us about your current practice: What areas of mental health is your focus? How large is your practice? What is the turn-over rate?

I work full-time as a psychologist in my private practice. My primary therapeutic approach is cognitive-behaviour therapy, though I also incorporate elements of dialectical behaviour therapy, as I see many clients with borderline personality disorder. I tend to enjoy working with complex cases, so I have a lot of clients with substance abuse issues, eating disorders, and personality disorders. In terms of how large my practice is, I currently see around 27 clients a week. I’m not sure what the turn-over rate is in my practice. I tried this year to incorporate progress monitoring into my work, in part so that I could answer that question, but I didn’t find it was a good addition to my practice at the current time.

PM:  What inspired you to write your book?  Were there some early challenges you faced that changed your approach to practice?  

When I first started my private practice, I kept notes for myself as to which promotional activities I was using and which interventions led to more clients. I was completely clueless as to how to build a practice, as I had not received any graduate training in this area. It even took time to become comfortable accepting money from clients, as it would lead me to question my worth as a therapist. Once I had achieved a level of success, I thought other therapists could potentially benefit from learning about the process of building my practice. In terms of early challenges, I feel like I am always trying to change my approach to how I run my business or how I work clinically. I always try to incorporate the feedback I receive from clients so that I can continually improve and evolve.

PM:  What are some of the key pearls you would give to a psychotherapist student in training about to transition into independent practice?

I have the belief that if you are doing quality work and clients enjoy their sessions, you will find success in this field. With that said, you need to be creative, persistent and confident in your approach to the business side of therapy. Keep trying new things to build your referral network, tell everyone you meet that you are a therapist, give out your business cards freely. It can be uncomfortable at first being so tenacious but if you are too passive, it will be difficult to build your practice.

PM:  What are some key areas you would tell an early independent practitioner to pay attention to?

It is vital to build an online presence. Start with creating a professional website. There are many hosting companies that will provide easy to use templates to design a great looking site. Next try to create a few social media sites, including Linkedin, and Facebook. Lastly, subscribe to a site like psychologytoday.com, where you can post a profile. These sites allow potential clients to get a sense for your approach and learn about your areas of specialization.

PM:  In your book, you mentioned using the internet and social media effectively to improve practice, how does one avoid the pitfalls as much as possible and maximize the advantages?

I would suggest that therapists pick just a few social media sites and focus their effort on creating great content for these sites. Also, make sure the message you are trying to communicate to clients through your sites is consistent. For example, if you specialize in anxiety disorders, ensure that this is prominently displaced in each of your sites. Create blog posts for clients outlining strategies they can use to manage their anxiety. This will help potential clients feel comfortable reaching out to you about booking a session.

PM:  How much time do these promotional/social media activities take up in your practice?

Now that my practice is established, they take up very little of my time, maybe 20 minutes a week. For those just starting out, however, they will need to invest time in learning how the various websites work and how best to maximize their utility. As with anything, if you want to create high-quality sites and content, it takes effort and time but it is worth it.

PM:  What is a reasonable share of overhead costs for promotional activities?

Expect to pay around $10-15 a month to host your website, along with $40/month for a psychologytoday.com account. A set of high-quality business cards from a site like Moo.com, will cost around $50. I would also suggest therapists have a professional photo taken, and that can run between $100-150. There are additional potential expenses but they are more discretionary. For example, paying to run ads on Google or Bing, or hiring a company to create your website and manage your social media. There are indeed some up-front costs but these will help you build your referral sources and spread awareness of your services.

PM:  In your book you wrote about ways to promote your practice outside of social media including network building and communication with doctors and other psychotherapy clinics, would you say that these approaches are more or less effective than social media?  Should a new psychotherapist focus more on building networks and getting in touch with referral sources/colleagues rather than spending too much resources on social media?

I would suggest that new therapists pick a few ways of building awareness of their practice each week and when they have achieved those goals, pick two new strategies for the next week, and so on. It can be easy to feel overwhelmed at first and to want to tackle everything at once, which just ensures that you will do a mediocre job at all of them. Start with building a website and send out a few emails to clinics in your city to let them know about your services. Emails take very little time and have no cost, so they are a good way of building business. Once you have your website, pick one social media site and try to populate it with information about your business, including a few nice photos. It is far better to take a more measured, systematic approach then a scattershot method.

PM:  How do you keep your records?  What are some confidentiality/record keeping standards that a psychotherapist has to mind?

All of my records, from my invoices, client notes, files, and questionnaires are done securely through Simple Practice (www.simplepractice.com). Simple practice is one of several therapy software management systems that allow therapists to go completely paperless, using cloud-based software. The reason I switched to an online system was because I found I was wasting a lot of time each day retrieving my folders in the morning, trying to keep track of who had paid and who needed to be invoiced. I much prefer the simplicity of having everything in one system on my password protected laptop.

 PM:  You discussed work-life balance in your book, what are some challenges or barriers to balance and what can a new practitioner do about it?

One of the most pervasive fears for most new therapists is, what if I don’t have enough clients? This fear can lead therapists to take on any potential client who contacts them, irrespective if it is in the evenings or on the weekends, or whether the client’s challenges are a good match for the therapist. It can be helpful to reflect on how much money you want to make each week and how many client hours you will need to achieve that goal. Otherwise, what happens is you adopt a mindset that I just need to see as many clients as I can and make as much money as I can. The other important ability is learning to say no to clients. This can be difficult for all therapists, but especially early in their career. They need to recognize though that if they are doing good work, and putting in the time to build awareness of their practice, the clients will be there. Also, if they are taking care of themselves and ensuring that they get adequate recuperation time, they will be more effective therapists and it will allow them to do this job for a long time.

PM:  What is the most challenging part of maintaining your busy practice?

The two most difficult challenges for me is maintaining my work/life balance and managing the psychological toll this job can have. In terms of work/life balance, I strive to see only 5 clients a day because when I see more than that, I am more stressed out about my day. I also try to exercise regularly and get a good amount of sleep each night. To manage the emotional toll of the job, I started a therapist support group that meets once a month to process our difficult cases, and I try to engage in meditation and mindfulness to stay present.

PM: What is the best part of your job?

Being in full-time private practice means I am completely in control of my schedule. If I want to take a week or a morning off, I have that flexibility. In terms of the clinical work, I love the intellectual challenge of figuring out how to help a client. I really enjoy seeing my clients improve and regain their hope and a sense of meaning. There aren’t many jobs where there is so much immediate feedback on how well you are doing.

PM:  Thank you Dr. Morris for taking time out of your busy schedule to give us this interview.

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The views expressed in these blogs are the author’s own and not necessarily reflective of those of Psychotherapy Matters.  Information provided here and anywhere else on PsychotherapyMatters.com is for learning purposes only and should not be used to guide treatment of clients/patients. Copyright © 2019 PsychotherapyMatters.com

Vicky Nguyen

Vicky is a psychiatrist and recent graduate from the Northern Ontario School of Medicine (NOSM). She completed her PhD and MD training at the University of Toronto. Her research interests are directed at promoting innovative practices and policies to address sub-optimal wait times, access, equity, and quality of health care services for disadvantaged populations in Ontario. She is certified to provide IPT and CBT. She is trained to provide other types of therapy including DBT, and Psychodynamic Psychotherapy.

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