[00:00:00] Linzy: Hello and welcome back to another Feelings and Finances episode of the Money Skills for Therapists podcast. These are our Friday episodes where we answer questions from you, the therapists and health practitioners who listen to the Money Skills for Therapists podcast, and we also just generally keep things short and sweet.
[00:00:19] This is your little bit of financial num nums, your financial snack, if you will, coming into the weekend.So today, I’m going to be starting a little mini series, a mini series within a series. Feelings and Findings as being a sub series of our podcast,
[00:00:37] this being a mini series of that sub series on the biggest mistakes that I made in private practice. So I’ve been reflecting on what I did well in private practice, what came more naturally for me or I was lucky to learn early, and what are the things that looking back I wish that I had done differently.
[00:00:55] So I’m going to start today with one of the things I wish that I had done differently, a mistake that I had made. I’m going to record a couple more episodes of mistakes, and then I’m going to also share an episode of things that I did well and that I’m really glad that I did early. So I’m really digging into my own experiences here to share about what I wish I had done differently looking back on being a therapist in private practice.
[00:01:17] So the first thing that I am reflecting on that I wish that I had done differently as a private practice therapist and that I wish that I had implemented a regular schedule system earlier. So this idea of having a regular schedule system came onto my radar probably around 2018, Tiffany McLain, I believe, is the person who put it onto my radar first, talking about this idea of having regular appointment slots for your clients, a spot that belongs to them.
[00:01:46] For instance, Tuesdays at 2 is their spot every week, and maybe they have a weekly spot, and maybe they have a bi weekly spot. But it’s this idea of setting up a regular appointment system in your practice, so you 90 percent of the time, or even 100, folks are coming at the same time every week or every two weeks.
[00:02:05] When I was first introduced to this idea, I had so much resistance. My clinical practice focused on trauma, developmental trauma, complex trauma, dissociation. So I was working with some folks who had quite severe dissociation, people who had trouble functioning in daily life sometimes, people who had a lot of charge and triggers around attachment.
[00:02:29] And I really convinced myself for a couple solid years that my clients would not be able to tolerate being asked to come to appointments at a regular time. I told myself that that would be demanding too much of the folks that I worked with, that it wouldn’t work for people, that I would lose clients, you know, all those normal kind of scarcity stories.
[00:02:48] But generally speaking, I really held this belief that my clients could not adhere to a regular appointment system with me, that they needed more flexibility. They had other appointments they were managing. It would be too much to ask them to make a commitment to a certain spot. And I really believed that for a couple years. When I finally got to the point of rolling out the system it was because I had to, like I was feeling exhausted and overwhelmed by my schedule and I I knew that as a full private practice clinician, my schedule shouldn’t be painful.
[00:03:21] Like when you get to the point where your practice is full, that should not be causing you duress and stress, right? That should be a point where we breathe as clinicians, and can, you know, cruise a little bit, be at a nice cruising altitude. And instead I found, I was having a hard time fitting all my clients in.
[00:03:37] I was bending my schedule to fit somebody in because I didn’t want them to miss a week, but they weren’t available for the spot that I had available the following week. So by the time I rolled it out, I had quite a bit of scheduling pain in my life. It had become a real headache. And when I first rolled out the idea that I was going to be starting a regular appointment system, I did it in a really intentional way.
[00:04:01] Really glad I did that, that was not a mistake, of creating a letter for my clients. I find I share this letter now often with my students in Money Skills for Therapists as an example of how you can communicate about a regular appointment system and why you’re implementing it. That letter includes the value of regular appointments, what it does for them, what it does for me, and it includes helping them understand that they have some responsibility in therapy, that it’s good for them to hold some responsibility for coming at a regular interval, that clinically that’s very helpful.
[00:04:34] the letter laid out what’s helpful about it, laid out how it was going to work, was very clear on the number of cancellations which people got. And I know some folks who roll out regular appointment systems do it with, you know, a very limited or no cancellation policy.
[00:04:47] I didn’t feel that was appropriate for my clients. So I rolled out, I believe it was that they could have three free cancels in a year. And then after that, you know, there would be discussion about whether or not maybe the spot wasn’t working for them anymore. So when I rolled it out, I was anticipating the worst.
[00:05:04] I thought people would, say, well, that’s not going to work for me, other kinds of objections. You know, your brain comes up with all sorts of stories. And what I remember instead is a young client that I had, which is somebody who I would have thought of as more vulnerable, somebody I didn’t want to demand on, for coming to regular intervals. When I told her about my regular appointment system, she literally jumped for joy in my office. And I was like, okay, this is just as beneficial to my clients as it is to me, right?
[00:05:31] Because what it meant for her, from a client perspective, is now she could see me every week. She could see me every week on Thursdays at one o’clock or whatever time. And she didn’t have to have that anxiety of maybe the next week the one or two spots that I have available, or even three or four spots, don’t work for her and then she’s not going to see me at all, right?
[00:05:51] There’s a cost to our clients when we don’t have regularity in that every time they go to rebook with us, they’re kind of rolling the dice, right? Or I know some practitioners that I see who don’t have regular appointments slot systems, and it might not make
[00:06:04] as much sense for the types of treatments that they offer, I’m having to book way ahead to know that I’m going to be able to see them as often as I need to see them to get the treatment that I need. Right? So that puts a lot of stress on me as a client if I’m, you know, having to book several months ahead and then I know oh shoot if I have to cancel those appointments I’m not going to see them for another several weeks until my next appointment.
[00:06:25] Having that regular appointment slot lets your clients know that people who are coming weekly or bi weekly, their needs are going to be met. I wish that I had done this so much sooner. The other benefit of doing this is that I could actually see when I was full. And I love doing this with my students in Money Skills for Therapists when schedules is a challenge for them, where we can lay out a schedule.
[00:06:49] You know, if you’re listening now, you can totally do this yourself. Lay out a schedule. Of course I use a spreadsheet, but it could also be a word document to show, you know, this is my week. These are the spots that I have available. These are the times that I can work. This is the most sessions I can do in a day,
[00:07:05] so I’m going to schedule, you know, those four slots available. Who has those slots already? Like who’s already kind of regularly seeing you on Tuesdays at 10? Put their name in there. And then if you’re somebody who sees clients biweekly, cause I tended to see clients more biweekly than weekly, actually, for the type of EMDR work I was doing that worked well for my clients and I, I’d have a week one, week two.
[00:07:25] So I know that on week one, Jim has this spot, and week two it’s Lorraine, right? And I know that they rotate. And so by having set spots, you can also see, are you full?Because that’s another thing that I struggled with as a practitioner and that I see my students in Money Skills for Therapists struggling with is, you don’t know when you’re full, right? If your schedule is all over the place, if some weeks you’re going to have 10 sessions and the next week you have 18, are you full?
[00:07:48] Are you not full? Do you have room for more clients? Do you not? When you start to set a regular schedule, you can actually see, okay, I work 15 sessions a week. These are the spots. When spread out the clients that I have, and I put them into regular spots, I have three weekly appointment spots left. Now you can actually make informed decisions about how many more clients
[00:08:10] you take on, what type of spots are available. You can think about even how you spread out your schedule and how to distribute clients so that you’re balancing your days better, right? So you’re not having one day that’s like so intense that you’re exhausted at the end and then the next day is light, but you feel burnt out from the day before, so it doesn’t really matter.
[00:08:26] Yeah. There’s so much benefit to having clarity. Folks who listen to this podcast, or who have taken Money Skills for Therapists know that clarity is one of my favorite words. Having the clarity to know is your practice full? Is it not? And if it is full, then you can move into those bigger questions of financially,
[00:08:43] is it meeting your needs? Is seeing your sweet spot amount of clients, your 15 clients a week or whatever, do you actually get paid enough? Or do you need to start thinking about other things that need to change in your practice? You can only know those things when you actually know if you are at capacity or not.
[00:08:58] So I wish that I had rolled this out at the very beginning of my practice. I probably didn’t roll out a regular appointment system until four years into my practice. And the four years before that had a lot of headaches that were unnecessary. And the final years where I had my regular appointment system had much more clarity, flow, my clients felt taken care of.
[00:09:18] It helped with their attachment needs because they knew they were going to see me. They didn’t have to worry about whether or not they were going to get in for an appointment. It also meant that if they knew that in three weeks they were going to be on vacation or they had another appointment on that day, we can either reschedule within that same week or we could choose to skip that week or see them twice the next week.
[00:09:38] You know, we could actually plan ahead as a duo, right, as a team in supporting their mental health, rather than it kind of being left up to chance. So, if you are listening and you do not have a regular appointment slot system, I strongly encourage you to think about it. If you have objections internally, I would encourage you to interrogate those a little bit.
[00:10:00] You know, if you tend to work with folks who work shifts, because that’s something that I hear sometimes, it doesn’t work for people, you can still have 50 percent of your clients on a regular appointment slot system, and then have floating spots for those folks needing more flexibility. It doesn’t have to be all or nothing, but the more that we can create that consistency and regularity for us and our clients, the more regular your income is going to be, the more consistent your care for your clients are going to be, and the more clarity you’re going to have in where your practice is at.
[00:10:27] So it’s something I’m very passionate about consistency, very passionate about stability, and I love the regular appointment slot system for that. If you have a question you’d like me to answer on one of these feelings and finances episodes, I would love to hear from you.
[00:10:42] All you need to do is click on the note in the show notes or head over to our podcast page. You’ll see a little spot to say, record a question. All you need to do is press record, introduce yourself, share a little context if you’d like, and share your question. And I would be so excited to answer it on one of these feelings and finances episodes to send our fellow therapists and health practitioners and coaches off into the weekend with just a little financial nugget to take into the weekend with them. Thank you so much for joining me today.