Thursday, March 1, 2012

Office, check; supervisor, check; license application, check; website, check (sort of)

I've made a lot of progress, I just haven't had a chance to post! First of all, I've signed a lease to rent an office 1 day per week. I like the neighborhood, I like the building, I like the office, and I like my landlords. So I'm pretty happy about that, and it allows me to move forward with other things, like getting business cards printed and publishing my website. More importantly, I have an office, which makes my practice feel much more solid and grounded. Now that I'm paying rent, I'll be more motivated to start getting clients.

My rent is about $25 / week, that is, per Saturday. I think that is pretty reasonable, and it does not feel like a huge financial investment. My first day is this Saturday, and of course I have no patients yet, but I think I'll go there, soak up the atmosphere, and maybe do some writing.

I can't start seeing clients yet because my Associate license is still being processed. That's another bit of progress I've made: I completed the application, settled on a supervisor, and submitted all the paperwork. This included an official MSW transcript; and a certification of my license from New York. It's been about a week, and according to the DOH updates, it is now being processed. Who knows how long that will take, but I'm hoping I have my license number in the next week.

I weighed the risks and benefits of going "live" with my practice, and only scheduling any new clients in two weeks or so, hoping that I'd have my license in time; but I decided that that was too risky - for all I know the application will be delayed and then I'd be in a weird spot. So I'm just getting my website ready so that I can go "live" as soon as I have my license number.

Speaking of websites, I've been designing a simple site using themes. WordPress is a blog site but it is pretty simple, using pages, to tweak the blog so it looks like a website. You can also purchase a URL for your site, which I did a few days ago.

I'm still working on the website text - it is hard to know how much info too much info. I've noticed a trend in private practice sites: Its the scatter-shot method - mention as many specialties as you can, with the aim that something will catch the eye of the viewer. The general consensus I've seen is that it's actually better to focus on a niche. But since I'm starting out new, I haven't really found my niche.

Anyway, I tend towards simple, and I'm somewhat averse to selling myself, but I also want a website that will connect with potential clients, so I'm writing somewhat more than I'm naturally inclined.

In summary, I feel like I've made a lot of progress in February. My original "launch" date was Feb. 1; that didn't happen because I got a job. But I've made a lot of the second half of last month, and I expect that sometime in March I'll launch my website, start dropping business cards around town, and list myself on a few sites. Then we'll see if anyone calls.

Next Steps:

Malpractice insurance - can't decide which plan
Business cards - can't decide which design
Phone - do I need a separate phone or phone line?
Client info and disclosure statement - write it

On top of all this, I keep reminding myself that I'm actually going to have to do therapy too. That in itself is pretty intimidating.

Saturday, February 18, 2012

Submitted my License (Associate) Application

This week's progress:

  • Associate Licensing Application submitted (need that to practice under a supervisor and move towards full licensure)
  • Met with one potential supervisor. Grade: 7/10; meeting with another one in a few days
  • Beefed up the content of my website and worked out some kinks
  • Maybe found an office to rent!

Getting Licensed
I spent a lot of time yesterday and today completing my application for my associate licence (in case you haven't been reading, in Washington, you are an "associate" until you've gotten all the hours of experience and supervision needed to get a full licence.) It shouldn't have been a surprise, but it turned out to be more work than I expected. And it cost a bit more, too.

There were two main reasons for this:

  1. I didn't realize that I needed to request my M.S.W. school transcript. I had to request that... then it turned out that I never completed "Financial Aid training" prior to leaving, so a hold was placed on my account. So, even though I paid all my loans of a few years ago (Thanks, wife's savings!), I had take a bunch of on line quizzes about why defaulting isn't a very good idea. Well, I passed the training and I am now prepared to be a responsible lendee. I submitted evidence of that, and hopefully that will get the transcript processed.
    Cost: $9
  2. I didn't realize I needed to get official certification from other states where I've had licenses. I have a LMSW license in New York State. It doesn't help me at all in Washington, but just to be safe I'm having the New York State Dept. of Education certify that I have that license. I had to send the form in by mail, so who knows when it will get processed... (You can just look it all up online, anyway, so I'm not sure why the official certification is necessary).
    Cost: $20
After dealing with all that, I submitted the main application (Cost: $50). The only thing I am missing is the form that verifies that I am receiving supervision, and is signed off by an LMHC. I still don't have a supervisor, but I hope to have one by Monday (I'm still shopping around a bit). Once I decide I'll get the form signed and drop it in the mail. Then I will pray that all the pieces of the application come together into the same folder and get processed swiftly. (The WA DOH says they are processing applications who's checks cleared on 2/2/12, so it looks like there is a 2 week timelag for start of processing. That means I can probably only expect a license number by March 15 if I'll lucky.

I'll have more to write about this topic once I've chosen one for sure.

For now I am using a Wordpress theme that I've converted to look like a website. I can't afford to hire a web designer and I want to be able to change content and design easily. I am pretty happy about the look of my page. Still working on the content - how to describe your practice in the way you want? AND in a way that will attract clients? And what about the all-important photo portrait? Here's a post by Tamara Suttle on using professional photos for our websites, blogs, avatars, etc. I agree with her about the worst offenders of style or business common-sense, but It's still hard to figure out that sweet spot between formal and relaxed/natural.
I may have found a weekend office space that I like. The location is quite good; I like the style of the building a lot. Seems quiet. I'm not thrilled by the office furniture - I like chairs that are chairs, not mini sofas - but I can live with it. The one question I have is how to find a child-friendly space that doesn't look like a daycare - that is, where adults would feel good about going to - not full of toys, doll houses, etc.. I'm even thinking of just doing adults and adolescents in this office and, on another day, renting space in the evening for a couples of kids+family sessions. We'll see... And I'll let you know if I put down the money for the office: That will be a big step! I have to rent it for March, so hopefully my licensure application won't eat up that time. I will keep you updated!

Summary: I'm feeling pretty good about this plan. I get waves of, "who the hell do I think I am, a therapist?" and "What the hell will I do once I have clients?" and, "Will I have clients?" But overall, I'm excited.

Sunday, February 12, 2012

Slowly making progress

Several weeks ago I wrote about getting a new job. As predicted, that has taken some attention away from my practice. I am now 3 weeks into my office job, settling in (it's not as bad as I expected...or at least, I'm getting used to the badness!); I've gotten my first paycheck - that's always nice - and now I am moving forward with my private practice.

Progress report:


  • I've scheduled two meetings with potential supervisors
    • One is a man who works close to my home; I identified his website while looking at other therapist sites, and I like his clinical perspective
    • Another is a woman who is not quite as close to me, but who was recommended by a friend
  • Once I meet with them and choose someone, I'll be able to send in my LICSW-Associate application; that will take a while to process, but once it's done, I'll be able to legally provide therapy, which is kind of important
Malpractice Insurance
  • Here are some basic things I've discovered about malpractice insurance:
    • "Malpractice insurance" is the same thing as "Professional liability insurance"
      • This may be obvious, but it took me a while to figure it out
    • It is sold at an annual rate, and is usually quoted based on how much they pay out per and per year, e.g. "$1,000,000 per occurrence / $3,000,000 total per year"
    • The cost also depends on whether you work part-time or not; and sometimes when you graduated.
    • For some plans (like NASW - see below) the rate goes up each year, because you are covering increasingly more years back. So for the first year you pay, say, $40, but by year 6 you are paying for coverage for six prior years, so the rate is more like $150.
    • There are various deals based on what association you belong to, but of course you also have to factor in the membership fee, and the added benefits of membership.
      • Case in point: NASW costs $170 / year to join, and I can get part-time coverage for $44
      • This is a good deal if I am going to join the NASW anyway (I has a student membership which I let expire); but if I want just insurance, there are much better deals.
  • For your reference, here is a good link with a list of insurance coverage options for counselors, although I don't know how up-to-date it is, and obviously I can't recommend any of the plans listed.
  • I have not found an office. I had some options but I didn't want to start renting while my start-up was stalled, and now they are all rented.
More news later...

Thursday, January 19, 2012

Okay, back on track

The last two weeks have been tumultuous. I accepted a job in a field that is not directly related to mental health: I hadn't had any luck with social service agencies in the area, and it was time to start getting some paychecks. The job is a research position in the field of education; I'm still kind of bummed about this step, as it feels like I'm moving away from what I want, not towards it. This is more symbolic than real - I know I can always leave after six, twelve, or 15 months when something more relevant comes along - but can symbols still have a strong hold on our ideas about ourselves.

But I've come to some acceptance about this step. Now I need to make some progress on my practice: The whole point of taking this job (besides not becoming homeless) is to have the financial stability to move ahead with my licensure and with my private practice.

My current goal is this: By the end of the year I will have saved a decent amount of money; I will have 4-6 regular clients (I'd be happy with 4) on one day a week (and maybe an added evening); I will have made a number of mistakes and corrected for them, thus learning what I need to learn about what works and what doesn't, and honing my business into a well-functioning practice. Then I'll only be 4 months or so away from getting my license. I'm hoping that, around 2013, a promising part-time agency position will open up somewhere. I like the idea of working at a mental health center for 2-3 days a week and doing my private practice 2-3 days a week.

My plan of 'opening shop' by February 1 is looking like it needs scaling back. I still need a supervisor signed on, then I need to file the forms with the Dept. of Health. I need to write my blurbs, website, etc.

But as long as I take it one 'action step' at a time I think I can move forward. Stay tuned!

Sunday, January 15, 2012

Running out of steam...

Last week I made a lot of progress... this week I've been running out of steam. This is in part because of my potential job. I mentioned in the last post on 'progress' that I'd gotten a job. It's not a job I particularly want, but it would give me financial stability as I start up my practice. I originally wanted to work 3 days/week, but they pushed for four. This would only leave one weekday (probably a Monday) for my practice, and maybe a weekend day.

I'm still in negotiations over salary, but I've found that my spirit is already somewhat broken, at least temporarily. I'm afraid I won't have the time or energy to really focus on my practice the way I'd like, and there's something about being forced to sell your time for money that just squashes the soul. In that mindset, it's hard to put a lot of energy towards something that feels like it's going to get pushed aside.

This job would entail some travel, and while they agreed that I could request to not travel on the day I have free for my practice, there's always a chance when they will "make" me go if it's an emergency; or, I might have to be in Nebraska on a Tuesday morning, and need to travel Monday night. This would seriously mess with my practice schedule if I have sessions on a Monday evening.

What to do? I think I still have to take the job, but I'm nervous. Maybe I should consider just doing my practice on a Saturday. I wish I knew if there was much demand for therapy on a day like that. Does anyone know? Where would I find out?

Also, my supervisor - the one I was really happy about finding - fell through. I have some more options, but I haven't had the energy to contact them - I need to find out what my work situation will be first.

So, that is all. Oh, and my business license came in the mail. I taped it to my office wall, and I also went to the thrift store and bought an in-out box. So that's progress, right?

At times like this, I wish I were independently wealthy. I recently saw, randomly, on Facebook, that the mom of an old class-mate had gone into private practice late in her life (all the kids in their 20s and 30s). She can rely on her husband's work and just take it up as 'lightly' as it were.

Not that I'm suffering - I'm very lucky overall. But I have to make sure my family has insurance and enough money first, and in this country that involves working in a salaried position. (remind me to make a tangential rant about insurance in this country, even though it's been made a million times; in brief: This country's healthcare system is fucked up!) My point is that it would just make things a lot easier if I could focus on my new business 100%.

I'm hoping once the job is worked out, or not, I'll feel more able to really focus on the business again - hopefully in couple of days.

Thursday, January 12, 2012

Two online resources for private practitioners

So, as I said in my last post, a pretty good week overall. One more positive: I found a couple of good on-line resources that I'm surprised I didn't uncover before.

  • First: Private Practice Blogs, which is basically an aggregator of other blogs on private practice. I haven't had time to check out the blogs they link to, but request that this blog be listed there!
  • Second: Private Practice from the Inside Out. Wow: A treasure trove of articles about the nuts and bolts of a private practice. I haven't had the time or energy to read much there, but I can tell that I'll be making a lot of use of Tamara Suttle's know-how.
  • Third: Mental Health Pros Lots of tips for private practice.
I will note, though, that as far as I can tell these blogs and sites don't focus specifically on the challenges of starting from scratch (I've found this to be the case with many of the books I've check out.) I'm sure if perused the archives I would find some good info on that. For instance, Tamara Suttle has a number of posts on insurance, preferred providers, etc., but I still wonder if as a LICSW-Associate (i.e. pre-full licensure) there is any way to accept insurance. My gut feeling is that the answer is 'no', but I'd like to know for sure. Maybe I'll ask her when I get the chance...

Wednesday, January 11, 2012

Progress and Procrastinations

I'm happy to report that I've made some important progress in the last week. I've also had a few steps I've been procrastinating on.


  • Made some progress with my website design (using WordPress templates for now - pretty easy, but I don't love any of the designs), and had a couple of friends look it over
  • Registered new business (sole proprietership - why? I'll try to write about that a bit later), and received UBI (but not the license, yet), which is the business ID I need to set up a business account at my credit union
  • Almost opened my business account - I went in and got all the info, but, since I want my wife to be a partner in the sole proprietorship, and since she's on the license, it turned out I couldn't open the account without her present. But that should take 5 minutes - hoping to do that before Friday.
    • (Side note: The main reason I want a separate business account is so I can put all my expenses on one card, which will make bookkeeping a lot easier I hope.)
  • I confirmed (per my most recent post) from the WA DOH that I CAN have a supervisor who is NOT an LICSW - more on that later.
  • Which brings me to: I think I found a great supervisor! It was based on a professional recommendation. We're not officially signed on yet - she's still checking on availability and details, but her background, focus, theoretical orientation, are great matches. Once we meet and make sure we're a good fit, I'll be really relieved because I was not looking forward to shopping around
  • I emailed several people about office space; one person required a 2-day/wk commitment, including a Saturday; another one caters to new practices, lets you rent by the hour, has family and play facilities, and is in a decent, although not great, location. I'm hoping to visit their site next week.
  • Oh, yeah, and I got a part-time job! I'll discuss that later, but I'm generally very happy about this development. It will put me and my family on a solid financial base, and I can start up my practice as slowly as I want, without feel pressure to make it grow faster than I feel comfortable.
  • I also went to the store and bought a bunch of office supplies
Okay, on to what I haven't done. Looking over my to-do list and action-step list, I see a few things that I am clearly resisting... 

  • Everything to do with writing content for my website and 'listing blurb' (is that what you call it?)
    • Why do I resist this? Despite being a therapist, I have a deep aversion to therapist language on websites - it just sounds fluffy, self-promotiony, and so on. How do I write something that is 'me' but also will attract strangers - basically, customers? It's much easier to do other things.
    • Also, I'm not quite out of the closet about my 'theripality' as it were. I have relatives who look down on therapy, or think it's crap; others maybe think, "What, Justin's a therapist?" This boils down to self-confidence, of course, but it's projected on others. How will I feel when my uncle or father-in-law or high school friends read my website? Can I take myself seriously and ignore what others think? Does part of me secretly think therapy is a load of crap?
      Here's a question for readers: What are the best private practice therapist sites you have seen?
  • Fill out LICSW Associate application form
    • There is a simple reason for this: I didn't have any printer paper; now I do, so I might as well get it filled out - especially the form I need my new supervisor to complete.
    • Come to think of it, maybe now's the time to have my OLD supervisor fill out my hours - that way I won't have to worry about him dropping off the face of the earth.
Next priorities on my agenda are:
  • Finish opening business account
  • Start writing content for my website and blurb
  • Make sure I have a supervisor and meet with her
  • Check out offices