Transcript
Speaker: made on Zencastr. Because Zencastr is the all-in-one podcasting platform that really does make every stage of the podcast production and distribution process so easy.
Speaker: Hello and welcome to the Independent Minds, a series of conversations between Abysida and people who think outside the box about how work works with the aim of creating better workplace experiences for everyone.
Speaker: I am your host, Michael Millward. In this episode of the Independent Minds, Patrick Islers, a master's level coach with Bloomworks Concepts in Coaching, will be explaining to me how to reconnect disconnected teams.
Speaker: Patrick is based in Detroit, Michigan. Not somewhere in the United States that I have ever had the opportunity to visit. But if I do get that chance, I will make use of my membership of the Ultimate Travel Club to make all of my travel arrangements.
Speaker: That is because membership of the Ultimate Travel Club gives me access to trade prices on flights, hotels, trains, holidays and all sorts of other travel related purchases.
Speaker: I have added a link with a built-in discount to the description so that you can become a member of the Ultimate Travel Club and just like me travel at trade prices.
Speaker: Now that I have paid some bills, it is time to make an episode of The Independent Minds that will be well worth listening to, liking, downloading and subscribing to, and probably good enough to share with friends, family, and work colleagues as well.
Speaker: As with every episode of The Independent Minds, we will not be telling you what to think, but we are hoping to make you think. Now, it's time to say hello, Patrick.
Speaker: Hi, Michael. Thanks so much for having me on today. i really appreciate a chance to be here and talk a lot about mental health and the mental health culture. That's great. Thank you very much. Could we start, please, with you just giving us a little bit of ah information about your background?
Speaker: Absolutely. Yeah. My name is Patrick Eilers. I'm a licensed professional counselor here in Michigan. I am also a certified coach as well. like I've been in the therapy world for about 10 years now. I've worked in a variety of different settings.
Speaker: basically from being a general practitioner, kind of working with everybody in all different types of diagnoses, many multiple different age groups, couples, groups of people as well, all the way up to being kind of a specialist.
Speaker: So my entire experience of walking through as a therapist, yeah I've worked yeah different variety, of different outpatient settings. So kind of a differentiation between inpatient, outpatient. Inpatient is more of a a hospital setting. you know You're there for a limited amount of time. Outpatient is more your traditional type of therapy. You come in and you can be there for as long as you feel like you need the treatment, need the help, need the support.
Speaker: um So I mostly worked in the outpatient world. going End of 2024, I decided that I'd seen a lot of places I'd worked for really had a lot of unhealthy cultures. And my culture definition is just places that people want to come to work.
Speaker: um I kind of started looking into some different things. I had a mentor encourage me to look into consulting. And I started exploring the idea of what it would mean to start helping practices, mental health businesses themselves be healthier.
Speaker: And so I started this journey of kind of working toward understanding and helping people as owners and as therapists together learn how to to manage that dual role and to start kind of standardizing some things and practices that are not typically standard, at least in the United States anyway. Right. So that's kind of where I'm at. And and I still work as ah as a contractual therapist as well. But I'm hoping to continue to build this this business into being something I do full time.
Speaker: So it sounds like what might be happening is the that old expression, the cobbler's children always have the worst shoes. So the people who are involved in supporting other people with their mental health are not necessarily looking after their own mental health as well as perhaps they could. Yeah, that's true. There's a ah lot of owners have a hard time sort of finding that balance between being an owner and also being a therapist. And then they're two different hats.
Speaker: A lot of times you have to kind of give up one in order to be able to be more successful than the other. And there's a lot of therapists, so I feel like they they kind of have a hard time, you know, giving up the therapy side of it in order to become a more so you know strong, as a stronger owner, basically. and then if you add people to your practice, I mean, if you, you know, have other people that work under you or you partner with or whatever,
Speaker: you run into a lot of you know time management issues. you know People have to definitely spend more time with the people that you hire in order to be seeing the execution of your vision of the of the practice to be carried out. Your practice is an extension of you you as a therapist. And so a lot of people may be really wonderful therapists, but they really struggle on the business side of it. What I've i've experienced in in many places that I've worked at is that a lot of owners are overwhelmed And they really don't know what to net and what the next steps are. They don't have a lot of good systems in place and they don't have a lot of standardization. So what ends up happening is it's kind of, they take what has worked in the therapy setting, which is a different type of setting, and try to apply that into being an owner. And and a lot of times it doesn't work and they end up having a lot of boundary concerns. And like said, time management's always an issue. And Certainly just the ability to be able to balance themselves.
Speaker: So that's something that I you feel like i'm very passionate about as far as help having these practices be able to be more balanced, not only for owners, but also for the employees that they that work for these these organizations.
Speaker: You've identified an issue in a relatively new industry, was coaching counseling 20 years ago was not the same as it is now.
Speaker: My HR professionals hat on, mean, Every manager in every type of organization goes through that. I am now no longer person that does the work. I am the person who does the work and manages the work of other people, some of whom will be partners, some will be colleagues, some will be contractors.
Speaker: But I am now not just responsible for myself. I am responsible for other the people. And that's something that everyone who goes from being the person doing the work to being the person who manages it,
Speaker: or the person who does the work as an employee to the person who does the work as a self-employed person that's a challenge a process that is a challenge for everyone who goes through that what sort of specific issues do you think are the biggest that people that you've been looking at and working with? From an owner perspective, there's a lot of owners who feel like it's it's not their practice. That's the one that's struggling.
Speaker: A lot of people, I think, certainly believe that the way that the field is set up because of a lot of the ways that, especially the United States, way insurance pays for things and the lack of Really being able to get people who you're treating to be able to work from like ah a self-pay type perspective is something that comes up a lot. The other thing I would say is is being able to find therapists who want to stay in a place. A lot of therapists are kind of taught to find their own way in school, meaning that what works for them as an independent pra practitioner in their session, whatever works for them is really kind of the best
Speaker: way to do something, right? You learn how to do it, but you learn how to do your version of it kind of thing. And what ends up happening is when you get out of school and you go to your first practice, let's say you work for, whatever that is, if it's inpatient, outpatient, doesn't really matter. You go from a very insulate insulated area in school where you have a lot of support. You have a lot of people talking you about a lot of things. You have a lot of details that are gone over very extensively.
Speaker: to a place where you're basically kind of left it left in the open, the support is definitely different. And some of that starts with supervision. So if you're an owner and you're also a supervisor and you're supervising other clinicians, that's certainly an area where, in my experience, this been a tough place for owners.
Speaker: So there's certainly that aspect of of those kind of things. I think they get overwhelmed pretty quickly, especially if you start you know expanding beyond you know one or two people that work with you. Because if each of those people see 30 people a week, let's say, now you're looking at you know somewhere between 90 to yeah over 100 people that are in the practice that are just clients. you know So there's certainly that aspect I think that happens. People get overwhelmed pretty quickly.
Speaker: Supervisees, you know, I think there's ah there's an there's not really an expectation of what to know, what to expect. So I think a lot of owners, you know, don't see that as necessarily a profitable area. They want to do it more so for because it's a kind of giving back to the field idea, but they don't really make the time for it.
Speaker: So there's certainly an aspect where as a supervisee, you're coming in and you don't really have a lot of support from the supervisor because they're not making their appropriate amount of time for that. So there's a lot of stories of that. I've been part of a supervision course. I have the supervision training I've done, and I've had a lot of colleagues share a lot of the same kind of experiences that they had that I had early in my career.
Speaker: Once you're in a particular area in the field, you know, that's an area you feel you you feel comfortable in. If you have to modify anything in your the way your process is, a lot of therapists try to get away from that. So they kind of just you know venture out on their own. And so that's why a lot of these therapists work independently.
Speaker: Then we have also the influx of all these people doing online therapy, which has really changed a lot of the way practices are run because there's so many people working independently. Now, on one hand, that's good because it does allow a greater amount of people to be accessed, you know, to have access to therapy, you know, as far as clients go. But the one downside for the field is that the field is very isolating. You know, as if I'm, if I'm only working myself at home online,
Speaker: You know, I don't have a chance to go out and you know talk with our colleagues unless I find our colleagues to try to have that relationship with. And and they're willing to have that relationship with me. So a lot of infighting happens within a lot of practices because, you know the right way and the wrong way to do things and that kind of thing. So there's also that kind of isolation within the field that is a pretty big struggle for for a lot of folks. So I feel like that's something I i also experienced as well at the beginning of my career.
Speaker: It sounds a little bit like, and I don't want to put anyone down at all, but it sounds a little bit like the way in which therapists are trained does not exactly prepare them for the work environment.
Speaker: And I don't mean the work environment in terms of the work that they have to do, but the work environment in terms of the context in which they will work alongside other people or individually and how they're going to manage that. So you end up, I suppose, as manager, having a group of people who have almost got the mindset that they're not part of a team, they're not part of a company, they're not part of anything. They're individuals and my profession is individually run.
Speaker: So I have to think about the individual rather than thinking about myself as part of a team. working towards the success of their business. Yeah, I'd say that's true. I definitely think there's a, it depends on the practice, but certainly there are certain practices. Yes, it's it's like we have a bunch of independent people who specialize in lots of different areas and they're all sort of working independently under this umbrella.
Speaker: And that's very common for that. um So yes, they're not trained to think about that. This is something that we're collectively working together. And ownership sometimes won't press that. You know like i said earlier, ownership tends to sometimes try to take a back seat to that and say, okay, we're just going to let everyone kind of do what they want to do so we don't upset them and we don't lose them. And I think that's why there's been such a high turnover rate. I know the research that was done in 2023 at the state of Michigan did was that there was a 40% turnover rate of therapists within the community mental health space, which is really kind of government funded.
Speaker: It's not necessarily, ah it's outpatient, but it's not necessarily a private entity. and um And just the working conditions of that. And it has to be said that sort of turnover rate of employees would make that professional job on a par with some low skilled manual jobs or repetitive jobs in offices. It's a very high level of turnover. Yeah. And so a lot of cases, that's where a lot of people struggle as far as being able to find that they kind of get into a place where they can learn how to be able to be a therapist and what to do and what not to do. And if they go out on their own, and they already have some things that are hard they struggle with as far as trying to find those balances and and to be the you know the sort of healthiest version themselves, I suppose is a good way of putting it. um
Speaker: Then, yeah, they're going to struggle to be able to be on their own independently. So you have a lot of that kind of thing that happens where you know there's just not a lot of this the support that's needed. And then definitely in the field, in the environment of these practices, there just isn't enough you know time to you know build into other therapists and keep people there and you know, that kind of thing. So there's there's a lot of factors at play, but those are some pretty big ones I would say I see quite often.
Speaker: Okay. So what does the owner of a coaching or counseling practice do to remedy this? what What would be the steps that you would say someone needs to take to re-engage or reconnect their disconnect? Yeah, I think for as if you're an owner, the the first thing you really have to start working toward is is being able to establish uh understanding the people that you're going to hire understanding that you're what's your philosophy of your practice so my the what i think i call the four p's so basically what's your philosophy of your practice you know what are your where's your the ultimate goal ah do you want to be ah a learning center for other therapists do you want to be a specialty practice do you want to look at something you know specific and or work with a specific population that's also one the p's is your population And then also, what is your process that you're putting together so you have enough, you know, be able to have enough structure around what you're doing so that doesn't just feel like we're kind of just, you know, outsourcing a lot of stuff or maybe we're actually not or so outsourcing anything. We're keeping everything in-house.
Speaker: And then that creates a certain amount of work that is things that, you know, people just don't have time to be able to do if you're trying to also care for for people. And then the last part is your kind of ongoing education. How do you continue to support these therapists that you're bringing in ongoing and continue to have that relationship with them and that rapport with them?
Speaker: A lot of folks will typically will will happen is that, you know there's this, you know, once they're kind of involved, then they have a certain amount of people that they're seeing or working with. um A lot of a lot of owners tend to get very concerned about the amount of people that they're not bringing in the door. So customers essentially or or clients in this way.
Speaker: And they tend to sort of hire people without really thinking about how they're going to move forward. but What's the, you know, do I just bring a therapist in to make sure that I have enough therapists to cover the need? Or do I have a good referral source that I need to send some people to before I start thinking about hiring somebody? So the scaling practice also doesn't necessarily work out all that well for folks. And so that disconnects a lot of people because you just kind of hire people that are available. rather than finding people who specifically are going to work with your but within your practice. Even just like the interview process of finding somebody needs to be altered a little bit because you can't just hire based licensure experience. i mean, those are important factors, but those are not the only factors which you can bring somebody else in. Is it going to gel well with your therapist? it going to be somebody who's going help facilitate, like you said, more team, more team building, more rapport building, that kind of thing. And typically that's something that a lot of owners don't necessarily factor in.
Speaker: So out of all of those factors, which one would you say is the the one that most people find it most difficult to actually master? Really kind of understanding how to you responsibly ah grow your practice, but at the same time, not limit yourself. I think there's always a fear that you're going to, because it's kind of consumer based, you know, as far as bringing people in, there's ah um an element of marketing that, yes, you have to do.
Speaker: But then there's also an element of that, that, okay, like if we do this one, if we are really good in this one area, people will get to know us for that thing, know, whatever that is that we're working with and they will come, you know, the more referral sources we have outside of necessarily just mental health help to, you know, sort of mitigate some of those things.
Speaker: I think a lot of people, they want to work independently and they really want it to be kind of what they want to do. Cause as I said, that's what you're kind of taught in school. And so it's hard to, to, to look at it as like being a collaborative process with other business owners or other people or other referral sources or whatnot. um Referral sources typically are, you know, hey let it let somebody know that we're here, not really a direct relationship. So that that usually causes, you know, if if you don't trust the person I'm referring you to, then I'm probably not going to refer you to. So it's a process. There's a lot of time it takes. you got to build into these relationships and rapport.
Speaker: And I think a lot of people feel like they do that with their clients. So yeah don't want to keep doing that with more people. But unfortunately, that's that's part of the process is you got to have good rapport with with other support systems around you. A lot of the places that I've worked for have not had great relationships with other other businesses, with other places that they could get referral sources from.
Speaker: The business owner who's trying to run a business with a group of employees in a profession that is expecting to be independent, that is the big issue that they have to address.
Speaker: Part of the solution, if my understanding of what you're saying is correct, is that running the business in an industry profession that is focused on being independent means that you need to have the marketing and the flow of new clients coming in that far outstrips in terms of quantity and quality what an individual person could achieve on their own so there is a value for them aligning themselves with your business otherwise they might as well just be by themselves Yeah, you know the more support they can have, I think that that also helps. Yeah, it definitely helps, you know, sort of the referral process and also just the report they have with other people. So are we saying then that instead of being acting like an employer, the business owner needs to act like a service provider.
Speaker: And very often, you know, when you're in a child like me, you'll talk about in the past, if you drew an ah an organization chart, have all the people that were reporting to everybody else and you almost ends up like a triangle.
Speaker: But from an individual manager's perspective, it's increasingly nowadays not that you are at the top of the triangle and looking down other people. You have to turn the triangle upside down and mean that all of those people that report to you are people who are depending upon you. So you have this weight of responsibility.
Speaker: to provide all of those people with everything that they need, even if it's the right type of space to work in, the right tools to use, the right electricity, lights, heating, air conditioning, like drinks to have when they want have a break, all those sorts things, that becomes your responsibility.
Speaker: And what you're talking about is that that is the the mind shift almost that the business owner, of the manager needs to make. in order to then attract and retain the people who are expecting and to be in a profession that is independent but they're actually looking for organisations who can help them find work and maintain a good flow of interesting high quality clients as well.
Speaker: Yeah, think that's good way of putting it. You know, certainly that can can can the owner. And I do think the big thing is owners don't necessarily always want to put that much time because they have the cuts into their own individual therapy you know aspect. So they have to cut out some of their time that they will typically work wheel know face to face with a client.
Speaker: in order to be able to be there for their business. And that's, I think that's one of the biggest, you know, if you're talking about just general issues that comes up is that, is that mindset mindset shift you just talked about. It's realizing that your business, you know, if you want to be an owner and you want to be more than just you,
Speaker: um there's going to a certain amount of time you're going to have to give up on the other end of it in order to be able to make that successful. Otherwise, it's just not going to be, is you're not going to have the kind of practice that you want to have because usually you know bad bad habits tend to breed more bad habits if we're not if we're not addressing them. so And that can definitely be if we're if we're independent and we just don't you know communicate, then that's going to definitely be things that are going to make it a lot harder going forward.
Speaker: So I like how you put that. I think that's absolutely part of it. Yeah. Whilst we're talking about a particular type of professional environment because of the way the rich professional work is changing there are more and more people who work in a in a profession who are going to be in exactly the same situation and accountants will have people working for them but many of them will be independent even even hairdressers in the uk at least going to a hairdressing salon and most of the people will be self-employed they're merely using the salon
Speaker: the facilities there to run what is an independent business. So whilst this may seem, or this is a particular type of environment, a particular type of business, the ideas and the, well, the challenges and the ideas and the solutions can be applied to many, many different organizations in all sorts of different professional environments, aren't they?
Speaker: Yeah, I think so. For sure. There's certainly a lot. I mean, what just brought up is very true. There are a lot of people who are kind outsourcing even just their they're building, you know, just for people to be able to utilize. And sometimes when you work for a place, that's part of your so your split that you have or your fee, so to speak, as an independent contractor is to pay for some of the things like space and stuff like that.
Speaker: So that is something that we do see. But yeah, I think that the one area that that's been changing is or one of the things that is is different. I mentioned it kind of earlier was the fact that because so many people have become Virtual therapists, a lot of these bigger companies that are out there, you know their their job is to basically just get as many therapists as they can get on kind of a roster.
Speaker: And then what ends up happening is they have a roster of therapists, but it doesn't necessarily mean they have the clients there for them. And again, it depends on kind of where you're at and which population you want to work with and stuff like that. Yeah, as an independent contractor, a lot of these places know that they can they can hire you without necessarily having a whole lot of people available to you. And that's one of the frustrations of scaling is that you have to be able to know that you're going to, or within than reasonable know, I think that you have enough people coming in that you're going to be able to you know take somebody else on. Because I've seen lot of circumstances where people just kind of panic and they hire they hire somebody and they assume that they're going to have the the workload for them and they don't. And that's when you're working with people or in a service industry like or someone of a service industry that we're talking about.
Speaker: i think that's one of the challenges that everybody has to face. but You know you can kind of reasonably know within metrics, I think that, you know, this is kind of what to expect or what is typically a busy time or whatever the case is.
Speaker: And a lot of therapists don't spend that time to kind of project that. They kind of just go with, this is the feeling that they get in this. There's gonna be a lot of people here right now, but that doesn't necessarily mean that that wait list is gonna be there. And, you know by the time you onboard somebody can spend $60,000 onboarding them.
Speaker: And then, you know, have nobody there for them to see. And that's a waste of the business's money as well to onboard that person. So that's another thing that does come up from time to time is that onboarding process and getting people in there in a timely manner, but also being able to you know that you're have some clientele somebody can see. Yeah, I get what you mean.
Speaker: So the big question is, tell us about an environment to the where you've put all this into practice in the and the results that they've achieved. So what we see with putting together a process, you know, what my process I think about is basically owner ownership ah is basically like a house. So there's a there's a roof and there's at the foundation of the home and and ownership starts at the roof. And so they're at the peak.
Speaker: and they oversee, you know, two types of managers, basically a clinic manager and a counseling manager. So somebody who actually has a background with the therapist and can relate to that and has that verbiage for them. And the clinic manager is somebody who can, you know, has an admin background or somebody who can, you know, run the day-to-day operations. And then everything kind of under that kind of falls into one of those two categories. And then that house sort of is a foundational piece of, you know, ongoing communication within those two teams. And This way, the therapist or the owner works within the two admins and then any additional things that need to be directed on, obviously they can address more. But I think the success you'd see with that is that it would create a structure that people would be able to see because it would be hierarchy that gives authority to people who are part of being in a managerial position rather than the owner taking all authority, which is usually typically common for most practices.
Speaker: um Having a a structure like that also helps to be able for a for therapist to understand the hierarchy of what that looks like and to know how we fit in the team, which is another part of that hierarchy. Because sometimes if you have a lot of experience, you know you get you get kind of a different level of maybe attention to some degree than maybe somebody who doesn't have as much experience or vice versa.
Speaker: um So there's the kind of the hierarchy piece. And I think the third part with that, but kind of putting that process into play is that it allows the practice to have some fail safes so that basically all the needs are met for the client so that, you know, the client continuity can go up. Because, um again, one of the things that typically happens when you have the turnover rate that we discussed earlier is A lot of lot of clients will leave those practices, and they may or they may not leave the practice, but they may work with two or three different therapists before their their treatment ends or before they feel like they've they've made to they me all their goals.
Speaker: And I've heard many people share that that's a real real frustration for them. And it's a frustrating thing for a therapist as well. On the other side of it, it's lose clients. But certainly if you're coming in as a client to work with multiple clinicians without building that rapport, or because rapport is a huge part of people being, you know, working and getting know healing in that way. And to always have to constantly build that rapport with somebody new really does not help the the field to get stronger. It really, I think, splinters the field more.
Speaker: So those are some things I think that definitely would say just got off the head that come off. Those would be affecting a practice in a positive way. When you talk about different types of people, different types of roles within an organization, when someone's setting up a business, in order to finance those roles, they either need a lot of investment or they need a lot of clients ready to join when they set up their business because of the on costs of actually having an employee beyond the amount of money that they're paid are substantial.
Speaker: And you need to have business coming in. So there's a part of me that sort of thinks when you are setting up a business as a founder, you almost need to be aware that you are going to have mindset shifts to move between those different roles before you've built the business to the size that can reasonably support having individual people in those roles. You've got to have the ability to shift your mindset between those roles, first of all.
Speaker: Yes, absolutely. There has to be an ability to be able to mind shut mindset shift in that sense. And like you said, certainly the financing is a big part. i mean, a lot of people go independent. They don't feel like the only thing they're going to have the cost is basically internet and you know you know QuickBooks or something like that.
Speaker: And the more they expand, you know, they can't just rely on those old systems that have worked when they were solo or whatever the case is. And sometimes they they do. And sometimes that's what they, that's one of the things that people run into is they try to in-house too much, too many things. They try to in in-house their billing. They try to in-house their scheduling. They try to in-house everything.
Speaker: And when they have a lot more opportunities to be able to pay probably less money to outsource it, um to be able to find that, you know, basically the balance between you know, running the day-to-day operations versus, you know, being the owner and dealing kind of the stuff that you have to deal with as an owner.
Speaker: um So that's another thing too. I think there's a lot of, you know, people that feel like it's cheaper to do it in-house. in the And what I've discovered is that just talking to other people in different professions throughout the last year is that there's a lot outsourcing opportunities that people could have if they would find and, you know, take the time to utilize, even just people who are working independently as a, you know, an an accountant, or maybe they're working as a biller or whatever.
Speaker: And a lot of those people don't necessari necessarily outsource those specific relationships. They tend to want to keep those in the in-house. So that's another area too where that comes up where if you can outsource some stuff, I think that helps to find more balance. Yes.
Speaker: It's fascinating just to think about how do you set up a business when you are by yourself and then how do you scale it and the mindset shift that you have to go through in order to achieve that successfully so there's only so much time that we have patrick but you know if people want to find out more which website should they be going to so you can contact me through the email email is bloomworks one word cc gmx.com you can also reach me at my patreon site it's patreon.com bloomworks and then you can also find me on linkedin as well as i'm on there patrick eiler's malpc great thank you very much really do appreciate your time today it's been been really very interesting. Thank you. Thank you so much, Michael. Appreciate Pleasure.
Speaker: I am Michael Millward, Managing Director of Abbasida. I have been having a conversation with the independent mind, Patrick Eilers. You can find out more about both of us by using the links in the description.
Speaker: I'm sure that you will have enjoyed listening to this episode of the Independent Minds as much as Patrick and I have enjoyed making it. So please give it a like and download it. so that you can listen anytime, anywhere.
Speaker: To make sure you don't miss out on future episodes, please subscribe. Remember, the aim of all the podcasts produced by Abbasida is not to tell you what to think, but we do hope to have made you think.
Speaker: Until the next episode of The Independent Minds, thank you for listening, and goodbye.
