Selling The Couch | Melvin Varghese PhD

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385: 7 Daily Habits That Changed My Relationship With My Podcast (And Made It Sustainable)Written By Melvin Varghese PhD ,Podcasting can be an incredible way to grow your impact beyond the therapy room and is an excellent bridge to things like writing a book, course creation, or speaking at conferences. But without the right systems in place, it can also lead to burnout. After nearly a decade of podcasting, I've discovered seven key habits that helped me create a sustainable, long-term podcasting rhythm.

Design for Longevity, Not Just GrowthIn my first year of podcasting, I tried releasing episodes every week, believing that more episodes would equal more growth. While my download numbers increased, my energy plummeted.

The key shift? I began designing my podcast around my life, not the other way around. Now, I release episodes for two months, then take a month off to recharge while replays run. Summers and late winters also align with my daughter's school breaks.

Takeaway: Plan your podcast schedule to fit your lifestyle, not just for growth.

Check out my free podcasting workshop for more tips.

Capture Ideas DailyIn the early days, I'd stare at a blank screen, unsure of what to talk about. Now, I use a private Slack channel to store podcast ideas.

I gather ideas from listener emails, conversations with colleagues, and insights from books and podcasts during daily hikes. Regular idea capture ensures I always have fresh content.

Takeaway: Don't wait for inspiration—build a system to capture ideas daily.

Follow a Repeatable Episode OutlineWinging it made my episodes disorganized and stressful to record. Now, I use a simple structure:
Introduction: Pose a question or share a story.
Core Content: Share 3, 5, or 7 points (usually 3). 5 and 7 points lets your create longer content (good for SEO and trust building) but it's more challenging to have folks listen all the way through.
Conclusion: Recap and offer a clear call to action.

Takeaway: Use a consistent format to simplify production and improve clarity. This is an excellent article that has some podcasting scripts. If you want to take it to the next level, copy/paste a few of the script examples into Chat GPT and ask it to store it to memory. Then share a topic and three points you're thinking about and ask it to create a transcript based on the template you just provided.

Batch Record on Off MonthsInstead of recording episodes weekly, I batch-record 2–3 episodes in one session during my off months. For example, I record January and February's content in November and December. I think take a much slower pace in January and February.

Takeaway: Batch recording reduces stress and allows guilt-free breaks.

Warm Up Your Voice and EnergyLow energy made some early episodes fall flat. Now, I:
Drink warm tea or water with lemon.
Do deep breathing exercises.
Practice tongue twisters to loosen my vocal cords or do vocal warmups.

Takeaway: Treat podcasting like public speaking—warm up before you record.

Promote Your Own Offers FirstEarly on, I relied heavily on sponsorships. While sponsors can be great, it left my income tied to external budgets.

Now, I prioritize promoting my own resources, like my free Course Creator Starter Kit, before adding sponsor messages.

Takeaway: Be your own sponsor first. Our free How To Start A Podcast Guide For Therapists also has some great tips on monetization.

Engage With Listeners RegularlyI spend 10–15 minutes weekly responding to listener messages on LinkedIn or via email—often with personalized Loom videos.

This engagement helps me understand what resonates, stay motivated, and build genuine connections.

Takeaway: Treat podcasting as a two-way conversation.

Final ThoughtsPodcasting sustainably isn't about doing more—it's about doing the right things consistently. By designing for longevity, capturing ideas, following a structure, batching content, warming up, promoting your own offers, and engaging with your audience, you can build a podcast that lasts.

Ready to start your own podcast? Join my free Podcasting Workshop and learn the exact steps I've followed to grow a podcast to 1.8M+ downloads.

STC ELITE MASTERMINDLast Week to Join Our Online Course Mastermind. We’re in the final week of our STC Elite Online Course Mastermind launch!

This is a small group of thoughtful, purpose-driven therapists supporting each other as we launch an online course in 2025.

If you’ve been thinking about:

❇️ Creating an online course
❇️ Generating income that's not tied to client sessions
❇️ Getting your message out in a bigger way

Now's the time!

👉 Learn more: sellingthecouch.com/mastermind

👉 Book a 1:1 chat with me: sellingthecouch.com/mastermindcall

📌Not sure yet? Sign up for our free 7-day email course to validate your online course idea.

Transcript (AI-Generated)Melvin Varghese:
Hey there, it's Melvin. I hope you're doing well. Before we jump into today's session, just wanted to let you know that STC Elite, our mastermind for therapists creating their first online courses open for enrollment. If you've been thinking about creating an online course and have been a fan of the STC podcast and are looking to launch your online course in a community of other therapists, you can check out the mastermind over at sellingthecouch.com forward slash mastermind. or you can download our free online course starter kit. It's a seven day email course that'll help validate your course idea. That's over at sellingthecouch.com forward slash course kit. We'll jump into today's session. Hello, hello, welcome to today's session, Selling the Couch. I hope you're doing well, having an awesome day. So today's podcast is titled Seven Daily Habits That Changed My Podcasting Journey and Made It Sustainable.

If you've been thinking about creating a podcast this coming year, then I hope that today's podcast session is incredibly helpful for you. I, this is also something if you are already a podcaster and you've thought about whether, man, like I want to keep this podcast going, but I'm not sure if I can keep it going. I think that today's session will be helpful for you. More than anything, trust me, I've been there. Podcasting is one of the best ways to grow your impact beyond the clinical room, but it can also be overwhelming, especially if you don't set it up for the long game. Everything from editing to uploads to actually releasing content and all of that stuff. I have been podcasting for a decade now. Well, it will be 10 years next month. And I remember when I first launched the STC podcast in March of 2015, I just remember one of the things I kept thinking was, oh my gosh, am I going to get stuck on the content creation hamster wheel?

That's the last thing that I wanted to do. But now we're over 380 episodes of the podcast. We are just about to hit 1.82 million downloads. And recently I learned the podcast is now in the top 0.5% of all podcasts in the entire world. And as I was creating this, I think the most important thing is I don't podcast like every week of the year. In fact, it's actually just the opposite. I've really tried to build this podcast around the life that I want to live. versus just releasing episodes for the sake of it. Now, having done that for the first year and quickly realizing how this was a formula to burnout. So if you want a sustainable podcasting rhythm that doesn't burn you out, I think this podcast will be helpful for you. So just in terms of the actual habits. So habit one is designed for longevity and not for growth. Designed for longevity and not growth. In my first year, I literally tried to release a podcast episode every single week. I had some podcasting coaches. I was in the podcasting space. And they all kept saying, the more episodes that you release, the bigger your download numbers are going to be, the faster your podcast is going to grow. All of those things. And those things are actually absolutely true. What they often fail to mention is that Trying to release a podcast episode on a weekly basis for all of the year is a quick formula for burnout.

And now one of the things that I have shifted in my mind is I really try to design my podcast and the STZ podcast for consistency over decades, not just months. So my general rhythm with this podcast is I do two months on, which is where I basically release new episodes. and then I take one month off where we run replays of older episodes some of the most popular episodes from the archives. The summers and late winters I also take off and this is just aligned with our daughter's school schedule because again I wanted to design my podcasting workflow around my life and versus it becoming another thing that was you know, that I had to deal with. This schedule, what I have found, and again, I would say you don't have to necessarily follow my schedule, but really look at your life and mark off and block off the months that you actually don't want to podcast. I think it will set you up for long-term sustainability.

What I found for me is this schedule really keeps me energized and it prevents podcast fatigue. It also lets me come up with new content for the podcast that I am genuinely inspired by. I also get to do like some nerdy keyword research and figure out okay, is this actually stuff that folks are wanting versus this pool to just release episodes because I've got to get an episode out next week or something like that. So the big takeaway with this first point is put your podcasting schedule around the life that you want and don't, not the other way around. So don't end up podcasting, you know, on a unsustainable pace and then you either burn out or it compromises and gets into other domains of your life, i.e. your personal life, your relationships, your hobbies, those kinds of things.

Habit two is capture ideas daily. So, is a little bit embarrassing. But the very first months of the podcast, I would literally sit in front of a computer. And I would just stare and I would go, Okay, what am I gonna come up with? What am I going to talk about? And the truth is, that is really, really hard to generate content off of. So instead I do is I have a private Slack channel that's just for myself and within the Slack channel I have a little section that just says podcast episode ideas. And where do I get these ideas from? So the ideas are basically when listeners or SGC newsletter subscribers email me back with content we usually try to check in once or twice a year with regard to you know what episodes would be helpful for you. There are also just conversations I have with colleagues that I'm like oh this would be a really interesting episode because you know it just would be beneficial for for others. The other ones that I see are you know I'll look on like things like Reddit or when I post on LinkedIn the posts that tend to do well or have a lot of engagement and well is not always like number of likes, it's actually more looking at comments and engagement and as sort of a way to inspire me of whether it's a potential podcast episode. Other things I look at are, you know, I try to do daily hikes, so seven days a week. I'm usually at that point, if I'm not talking to someone on the hike, I'm usually listening to either a podcast or a book on Audible and or some sort of YouTube video. And that also allows me to just find new inspiration. Biggest thing I wanted to just share with you is never rely on inspiration in the moment. Capture ideas constantly so that you can have a constant pipeline when it comes to podcast content. So the big takeaway is a steady idea bank means that you're never scrambling for an episode topic. Habit three is to follow a repeatable episode outline. So I used to wing it when it came to podcast episodes. And part of this is I feel like every podcaster goes through this journey in the initial stages. You're just trying to figure out your own bearings and what makes the most sense for you. But now what I do is especially when they are, if so, you have probably noticed on the interview based episodes, I always come in, I do an intro, then we actually do the interview, and then I do an outro episode where I reflect and share some of the insights that I picked up on the podcast conversation. So that's what those interviews look like. On the solo episodes, what I generally do is I follow a framework, which is basically I introduce the episode by posing a question of what the episode is going to be about. I usually then share a little bit of a story, and then I do either 3 points, 5 points, or 7. In most scenarios I like to default to 3 because I'm trying to get in 5 and 7. That's just a lot of content. Like this episode has 7 points and I know that I always like try to balance that because I know that it's a lot of information to consume. But after that, I usually then just have a call to action. So what I really try to do is down, not all the time, I you know, I try to really rely on inspiration. But a lot of the solo episodes I tend to do tend to be focused on either podcasting or online courses. And those are things that I live and breathe, lived and breathe here over the past decade. It's also things that we have products and services related to. So it's just something to think about when you create your own solo episodes, think about products and services that you offer, and create episodes around that, and then have an invitation to, to join that product or a service. So the biggest takeaway is a structured outline means that you just get clear episodes and sort of a faster production time. So even as I am listening to content or looking on Slack, I'm like taking the idea and I will take the idea and I'll be okay, what's the story I can come up with? What are three talking points and what's the call to action that I can implement as a result of that? So habit number four is batch record on my off months. So instead of recording week to week, I actually batch record multiple episodes in advance. I found the most I can do is three episodes in one sitting, but usually two is a nice sweet spot for me. And so for example, for me is I'll record January and February episodes in November and December. This lets me take like real breaks in even in January and February while my podcast still runs. January, February also tends to be the months where our online course Mastermind launch is happening. So the thought of both recording solo episodes or interviews of the podcast while trying to do a launch, I learned that the hard way four years ago and I was like, I got to figure out something a little bit more sustainable. Hey, it's Melvin. I hope that you're enjoying today's podcast session. Just wanted to also let you know that STC Elite, our mastermind for therapist course creators, is now open for enrollment. If you've been thinking about creating an online course, and specifically if 2025 is the year that you want to create your online course, definitely encourage you to check out our mastermind. It's over at sellingthecouch.com forward slash mastermind. We launched this back in 2021 and since then over 60 of our colleagues have gone through our mastermind. It includes a ton of support all the way from live teaching, live feedback from colleagues and from our team to build out and structure your online course all the way to mindset coaching, all the way to access to our video editing and graphic design team so that you don't have to hire everything separately. We made it really super comprehensive and I think you're really going to enjoy it. Again, the link is over at sellingthecouch.com forward slash mastermind. Enrollment does wrap up at the end of August. So definitely encourage you to check it out and consider joining us. And again, we have a free email course. It's seven days. It'll help validate your course idea. I know that's the biggest struggle many of us are navigating of whether the course is actually going to make money. And we put all of this into a simple to understand email course that you can check out over at sellingthecouch.com forward slash course kit, sellingthecouch.com forward slash course kit. We'll jump right back into today's session. So why does this batching method work? Basically, it reduces stress. It kind of keeps my energy high. It also creates a little bit of a buffer for emergencies. Just a side note, one thing that colleagues will often ask me is, like, how many episodes, Mel, should I have in the bank so that it feels good? I find that the sweet spot is somewhere between three and six episodes in the bank. Six if you're, like, more, like, conservative and just want to be, like, extra cautious. three, I think three to four, I think is a really nice sweet spot. And I think beyond that, I find that there's usually things just in the world of news and things like that that are changing. And so if you get too far ahead, it's really hard to then go back. I suppose you can always create an episode and just plug one in, but it just makes it gives you enough flexibility to be like, hey, I'm far enough ahead, but I have some flexibility if I want to release an episode because something is inspiring me in that moment. Now, so the big takeaway is record ahead so that you can take guilt free breaks. And I feel that that's going to be just a lot more sustainable. Habit five is warm up my voice and energy before recording. So if you've ever listened to a there were some episodes in the past where I would just kind of my energy would be really low when it comes to recording the podcast episode. Now, I'm not a quote, unquote, like high energy in your face voice at all. But what I noticed is a lot of time there were times previously where I would just be fatigued and then I would try to record a podcast. What was happening behind the scenes is I was not doing any sort of a warm up. So I would just sit down, turn on my audio or now like turn on my video and then start to record without ever actually warming up. So I do a couple of things now. So I will usually drink warm tea or warm water with lemon. That's good for vocal cords. I usually do that before I even record and I usually will even have like a tea with me while I am recording just in case I have my, you know, I get a frog in my throat or something like that. Then I do a couple of minutes, usually about two minutes of deep breathing where I'm just centering myself. What I really try to focus on is not just the thoughts that are going through my mind, but just really focusing on gratitude, just the opportunity to record a podcast, to be able to share my thoughts, all of those things. And then, then what I will usually do is I will do some sort of a, you know, tongue twister, Sally sells seashells by the seashore, something like that, just to just to warm up my vocals a little bit. And something I've done in the past, which I don't do as much now, because just because my setup kind of limits me to have more of a sit down setup, I could do it into more stand up, but then it would just be more moving stuff around. but I have in the previous times when I've just recorded an audio only actually stood up to record a podcast episode. This is where a standing desk and then comes in really handy and also if you have one of these like mic clamps that you can just clamp to your desk as your desk moves up the you know the mic will move up with you so you don't have to then go and adjust like multiple things and all of those things. The biggest thing takeaway from this is treat podcasting like public speaking. Your voice just needs that warm up time. And I think doing that just can be incredibly helpful. Habit six is promote my own offers first and not just sponsors. Early on with the STC podcast, I relied on sponsors and we're always so grateful for sponsorships. I try to be super discretionary in terms of even the sponsors that we get on. But if I'm just being completely honest, and I think by and large, we did a good job. But in the early days of STC, because most of the revenue that STC was generating was coming from sponsorship income, I felt more pressure to accept sponsors because I wanted to keep the podcast going. And then I also wanted to pull back from clinical work over time, and I needed to replace that income. But over time, what I came to realize is we've worked with some amazing sponsors, and we continue to work with some. Of course, I try to, again, do my best to filter and sort, because I know how much trust that you have in me. But by the same token, I don't want my income tied to the marketing budget of a company, no matter how great the sponsor is. I did that for the first couple of years and income that I was expecting for to come in, didn't come in. And it just left me scrambling and stressed out and all of that stuff. And I just realized, yeah, that's not the game that I want to play. And I also realized that, I've mentioned this study a couple of times, but there was a study done in 2023-2024 by ACAS Media, and they studied all media personalities, both traditional media as well as digital media, and they found that podcasters are the most trusted media personalities. YouTubers are the second most. And so what I realized is there's The nature of podcasting is there's a level of trust that gets built. And so I just thought, why not start to just share my our own products and services on episodes. Now, here's kind of a next level. Now, we use captivate to do this as our podcast host. If you go to selling the couch calm for captivate for selling the couch calm forward slash captivate. There's a discount code there in like a free seven or 14 day trial. But basically, our podcast host allows us to run dynamic ads across all the episodes. So for example, if we have a, you know, even as you're maybe listening to this currently, we are mastermind launches happening, right? So I can run those ads across all our episodes versus just this one episode. So it doesn't matter if someone is listening to this episode or another episode, they'll still hear the ads for the podcast on the podcast. So generally what I have found, and I'll maybe do another episode on this, but we have found that not just like inviting to the paid product, but inviting to something that's even more valuable. So for example, any time that I do an online course-related episode, I'll share an invite to sign up for our free seven-day email course. This helps therapists validate their course idea. And it's an action-packed course. I spent almost $10,000 creating it. And it's just a high-value course. There's graphics and all this stuff that comes over email. That's just it's not like a typical email course. And so the big takeaway from this is be your own sponsor. Don't wait for external ads to make money. Finally, the seventh habit that I would share with you is engage with listeners on some sort of a regular cadence. It doesn't have to be every day. but really try to aim for it on a weekly basis. So what for personally for me is I try to set aside about 10 to 15 minutes every week to respond to listener DMs that come to me on LinkedIn or emails. And a little thing on this, I usually send like loom videos back. So I'll send a video response back. One, I just feel like in this world of, you know, social media and where the human connection, it's so easy to get lost, I think getting a personalized video from somebody, especially someone that's taken the time to write to me, I think it's a nice touch. I try to do that as much as possible. And then at a practical level, I find that the videos just take a little much less time for me to create than actually sitting down and like writing an email out. The other things that you can ask your listeners are what topics they want covered. You can also like check, you know, we have, I think, almost over 300 reviews of the podcast and 250, let's just say 250. I'm pretty sure it's over 300, but let's say 250. And so sometimes when I'll look on Apple podcast and see what the reviews are and what's like resonating for folks. So when I look at those reviews also, like it keeps me motivated, ensures my content is relevant to serving our field well. So the big takeaway is podcast isn't a one-way street. So engage your listeners on some sort of a cadence, whether it's daily or weekly like I do. So the seven habits again to sustain your podcast for the long term is design for longevity, not just for growth. Two is capture ideas daily. Third is follow a repeatable episode outline. Four is batch record on my off months. Five is warm up my voice and energy before recording. Six is promote my own offers first, not just relying on sponsors. and seven is engage with listeners on some sort of a regular cadence. If you enjoyed this episode and you are like Mel, I am wanting to start a podcast. I've been sitting with this for a long time. We actually have a free podcasting workshop. This takes a lot of lessons I've learned over the past 10 years, puts it into a 90 minute presentation. When I do these presentations, I believe in like high quality teaching. And so you can actually learn a lot of the tools and tips and how to record and all of that stuff in this free podcasting workshop. You can sign up for a day and time that works for you. It's an evergreen workshop, so it's got a bunch of times and slots available. It's over at sellingthecouch.com forward slash podcasting workshop. Have a great rest of your day and I will see you next time. Bye.

Narrator: Thanks for listening to the Selling the Couch podcast. For more great content and to stay up to date, visit www.sellingthecouch.com.

Melvin Varghese: Hey there, thank you so much for tuning in to today's session. Just wanted to also let you know that we have a free email newsletter that goes out every week. You can download it over at sellingthecouch.com forward slash newsletter. Basically that newsletter contains some of the stuff that's happening behind the scenes with STC and also with my life and how I'm balancing and trying to balance being both an entrepreneur as well as building a life around my family and my health as well. And it also contains the latest podcast episode and some of the stuff that I'm doing on LinkedIn, some of the strategies and things that are working for me. And then finally, a brand new section called On Mel's Mind, where I take a video or a book or a blog post or something like that that's inspiring me for that week, and I share how I'm implementing it both in my life and in my business. Again, you can download that over at signthecouch.com forward slash newsletter. And if you are one of the 3700 colleagues that have been a part of the email newsletter is so appreciate you and I'm grateful for your support. We genuinely try to make these helpful and and just based on the data and based on the feedback we're getting, it seems like we're doing a really good job. So appreciate you and I hope they have a great day.

timestamps00:00:00 – Introduction to Sustainable Podcasting
00:01:57 – Habit 1: Design for Longevity, Not Just Growth
00:05:06 – Habit 2: Capture Ideas Daily
00:07:17 – Habit 3: Follow a Repeatable Episode Outline
00:09:49 – Habit 4: Batch Record on Off Months
00:12:50 – Habit 5: Warm Up Voice and Energy Before Recording
00:15:30 – Habit 6: Promote Your Own Offers First
00:19:22 – Habit 7: Engage with Listeners Regularly
00:21:41 – Conclusion and Free Podcasting Workshop Invitation

selling the couch podcast with melvin varghese phdWeekly interviews, strategy, and advice for building your private practice in and beyond the therapy room.

Apple podcastsYou TubeSpotify ready to launch your podcast?Please check out our FREE podcasting workshop for therapists (and therapists turned coaches and consultants).

This workshop is pre-recorded so you can watch it on a day and time that works for your schedule.

It contains a lot of practical tips that we've learned as STC has reached 1.81 million+ downloads and become a 6-figure business with podcasting as the backbone.

Melvin Varghese, PhD is a licensed psychologist in Philadelphia, PA. In 2015, Dr. Varghese founded Selling The Couch, a podcast to help therapists move from clinical to online income.

On the podcast, he interviews successful practitioners about how they've built their practices, social media/marketing experts, and shares lessons as he uses our clinical skills to create an online business powered by podcasting + online courses.

The podcast is one of the top Career podcasts in Apple Podcasts, has been downloaded over 1.8 million times, and is heard in over 125 countries. Mel is a successful course creator with 240+ students and $300k+ in course sales.

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384: Should I Hire An Intake Coordinator For My Private Practice?Written By Melvin Varghese PhD Should You Hire an Intake Coordinator for Your Private Practice?Is it time to hire an intake coordinator? Many private practice owners find themselves overwhelmed by client inquiries, scheduling, and administrative tasks. As a solo or group practice owner, you may be wondering if bringing in an intake coordinator is the right move for your business.

Recently I had the chance to sit down and record a podcast (you can listen or watch above as it dives deeper into things), but in this post, we’ll cover:

✅ What an intake coordinator does

✅ When solo and group practitioners should consider hiring one

✅ How an intake coordinator can improve client conversion rates

✅ The biggest mistakes therapists make when hiring an intake coordinator

Let’s dive in.

What is an Intake Coordinator?An intake coordinator (sometimes called a client care coordinator) is the first point of contact for potential clients. Their primary job is to create a smooth, welcoming experience from the first inquiry to the first session.

Their responsibilities typically include:

✅ Managing initial client inquiries (calls, emails, website forms)

✅ Scheduling first appointments

✅ Handling administrative tasks like rescheduling, processing super bills, and updating client records

For many practices, an intake coordinator is the bridge between a potential client in need and a clinician who can help. When done right, they ensure that clients feel supported and guided—not lost in an overwhelming process.

When Should You Hire an Intake Coordinator?For Solo Practitioners

Most solo practitioners don’t need an intake coordinator. With the right electronic health record (EHR) system, automation tools, and online scheduling, solo clinicians can efficiently manage client inquiries.

However, you might benefit from hiring an intake coordinator if:

✔️ You’re seeing 20+ clients per week and feel overwhelmed

✔️ You run additional businesses, coaching programs, or speaking engagements

✔️ You need help managing calls, emails, and administrative tasks

A virtual assistant trained in mental health intakes could be a great alternative. Many solo practitioners hire part-time intake support before fully committing to a dedicated role.

For Group Practices

If you own a growing group practice, an intake coordinator is one of the most valuable hires you can make. Many group practice owners wait too long to delegate this role, leading to missed calls, delayed responses, and lost potential clients.

Signs you need an intake coordinator:

✔️ Your practice has 5+ clinicians and is actively growing

✔️ You’re personally handling intake calls but don’t have time to respond quickly

✔️ Your conversion rate (inquiries → scheduled clients) is lower than expected

According to industry benchmarks, private pay practices typically convert 20-40% of inquiries into paying clients, while insurance-based practices see 40-80% conversion rates. A well-trained intake coordinator can significantly increase these numbers.

Common Mistakes When Hiring an Intake CoordinatorMany therapists struggle with delegating client intake because they feel no one can handle it as well as they do. But as Uriah Guilford, founder of Productive Therapist, explains:

“I thought hiring an intake coordinator would result in lower conversion rates. Instead, they performed better than me!”

Here are some of the biggest hiring mistakes therapists make:

🚫 Waiting too long to hire: By the time many practice owners realize they need help, they’re already overwhelmed. Hiring proactively prevents bottlenecks.

🚫 Not providing enough training: Intake coordinators need guidance. Set up a structured training plan, conduct mock calls, and offer regular feedback.

🚫 Giving too many contact options: Many therapists overload their websites with choices—call, text, email, online form, fax, mailing address. Too many options create decision fatigue. Instead, choose one primary contact method and guide clients toward it.

How to Retain a Great Intake CoordinatorOnce you find an amazing intake coordinator, you want to keep them. Here’s how:

✔️ Pay them well: Competitive pay prevents turnover (here's a helpful Reddit chat on what it's like to be an intake coordinator).

✔️ Offer benefits: Even part-time staff appreciate perks like flexible schedules or professional development stipends.

✔️ Foster a positive work environment: Avoid high-stress bottlenecks and support them with clear workflows.

A happy, well-trained intake coordinator will not only increase conversions but also free up your time so you can focus on your strengths as a clinician and business owner.

Final Thoughts: Is It Time to Hire an Intake Coordinator?If your private practice is growing, overwhelmed with inquiries, or struggling to convert potential clients into booked sessions, hiring an intake coordinator might be the next best step.

For solo practitioners, automation and online scheduling might be enough. But for busy solo clinicians and group practices, a skilled intake coordinator can save time, increase revenue, and improve client experiences.

Want help hiring the right intake coordinator? Check out Productive Therapist’s Intake Hiring Starter Pack (Use code STC for 25% off).

What’s your biggest struggle with intake coordination? Let me know in the comments!

Transcript (AI-Generated)Melvin Varghese:
Hey there, it's Melvin. I hope you're doing well. Before we jump into today's session, just wanted to let you know that STC Elite, our mastermind for therapists creating their first online courses open for enrollment. If you've been thinking about creating an online course and have been a fan of the STC podcast and are looking to launch your online course in a community of other therapists, you can check out the mastermind over at sellingthecouch.com forward slash mastermind. or you can download our free online course starter kit. It's a seven day email course that'll help validate your course idea. That's over at sellingthecouch.com forward slash course kit. We'll jump into today's session. Hello, hello, welcome to today's session of Selling the Couch. I hope you're doing well, having an incredible day. So today's podcast is asking this question of, should I hire an intake coordinator for my private practice? Whether you are a solo practitioner or a group practitioner, I think this episode will be incredibly helpful for you and more than anything I think will give you some barometers in order to think about whether an intake coordinator does make sense for you.

I'm joined by Uriah Guilford at ProductiveTherapist.com. Uriah is based in Northern California. He's a group practice owner and also owns Productive Therapist which is a company that hire that has virtual assistants and intake coordinators and Uriah has definitely been through the fire has been a group practice owner since 2015 and has learned a lot about the intake coordinator journey hired many intake coordinators and has learned kind of what works and what doesn't work, what questions to ask, how to train, and all of these different things. We start our conversation with a really basic question of what in the world is an intake coordinator, just to make sure we're all on the same page. Then we dive into the more nitty-gritty, how would you know as a solo practitioner whether an intake coordinator makes sense for you? and how would you know as a group practice owner of when it would make sense for you. And then we dive into some of these responsibilities of an intake coordinator, how hiring the right intake coordinator can really help you get some of those hours back in the day, but also you can leverage that position into helping your practice in multiple ways. And then we get into data privacy. How do you think about and how do you handle data privacy? Because the intake coordinator presumably is going to be the first person that a potential client is talking to. And how do you sort of handle all of that kind of stuff? And I think Uriah's answer is pretty interesting, because it really does depend on the situation. And then we dive into a couple of different logistical things. What happens if an intake coordinator gets sick or goes on vacation? How do you sort of triage and handle calls that are coming in? What's a top mistake that Uriah sees clinicians making in hiring an intake coordinator? And then we wrap up with what are the metrics that Uriah thinks about when trying to determine whether an intake coordinator makes sense for both the solo and a group practitioner? I think you're going to really enjoy this conversation. Even if you have no plans right now to hire an intake coordinator, I think conversations like this are incredibly helpful because I think they help us to think about how we can design our practices in a way that is sustainable for us so that we're not trying to juggle all of the things that when it comes to private practice ownership. So here's my conversation with Uriah Guilford from ProductiveTherapist.com. Hey Uriah, welcome to Selling the Couch.

Uriah Guilford:
Thanks Melvin. I'm excited to be on your podcast.

Melvin Varghese:
I know we were just talking right before, man, I can't believe we touched base in 2018 and it's a little ridiculous. Like I have to like publicly apologize that it's taken this long for you to come on the podcast. You are doing some amazing things for our field, sharing some just like incredibly helpful things. And I'm thankful for you. Thankful that we get to have a conversation on intake coordinators and just the whole process of that.

Uriah Guilford:
Yeah, absolutely. It's one of my absolute favorite things to do to go out and collect resources and find cool things, whether it's software or podcasts or all kinds of resources for therapists and share them. That's like my favorite thing to do.

Melvin Varghese:
Yeah, that's so awesome. And I'm like looking at your background and I'm like, man, Mario, and we have like so many that's like back. What is that Mario like the Super Mario?

Uriah Guilford:
So look what's behind me is my original Super Nintendo with a tube TV. Yes, so I can turn around and play some Super Mario Brothers anytime.

Melvin Varghese:
How awesome is that? That like brings back good memories like original like Mario Duck Hunt, all that stuff.

Uriah Guilford:
So much fun.

Melvin Varghese:
So much fun. So you know, I had a bunch of questions for you. But I wanted to start here. I know that most of us probably know the answer on this, but I don't want to like make any assumptions. So what exactly is an intake coordinator particularly related to private practice?

Uriah Guilford:
Sure. An intake coordinator, sometimes referred to as a client care coordinator, is the person who's in charge and manages that initial contact between the client and the clinician. And they're really in charge of the whole intake process. And it's their job to create a smooth and welcoming experience for new clients. I like to say it's their role to kind of smooth the pathway from that first contact to the first session. And it's such a valuable and important role for the client experience and for the start of therapy.

Melvin Varghese:
I love the fact that you talked about it as a smooth path because I can imagine for many people to make that decision to call and seek out therapy is a hard one and then just making it a smooth and joyful process even from that call. And then also I know that I'm sure all of us have heard these stories where someone reaches out to a therapist and they never hear back, right? So there's that other side of it, of the courage it took and then not hearing back. And then the other side of it, right? As clinicians, like, you know, clinicians maybe are perhaps slammed or whatever it is, right? And they're just not able to recall. So there's just, there's so many layers to it. And I love the fact that you use the word smooth.

Uriah Guilford:
Yeah, there are so many challenges on both sides. And interestingly enough, in the last two weeks or so, I've been doing a handful of intake audits where I'm actually sort of reviewing people's intake process and pretending to be a client from landing on their website to reaching out, filling out their form, even going so far as to get added to their EHR as a client and go through the consent form process. It's super interesting to see it from the client perspective. And one of my conclusions is that it's still too hard to find a good therapist and actually start and complete the process to get in to see a good therapist. Even with all the resources that we have now, it's still very, very difficult.

Melvin Varghese:
When you were doing that whole like audits like that, where did you see like the common hiccup? Is it just the amount of steps that we're taking or what was that?

Uriah Guilford:
Yeah, there's a number of things. The first thing that comes to mind is the challenge of actually finding a therapist and then reaching out and getting a quick response. So almost no one picks up their phone. That hasn't changed in years. Some larger group practices maybe have an intake coordinator that can answer the phone line, which is really helpful. But the majority of the time someone is calling or even reaching out by text to a therapy practice, there's a delay of hours to days to actually get things started. So it's just really slow.

Melvin Varghese:
The other thing you mentioned is you went through websites and like filled out forms. Have you found anything like that where majority of clients are like filling out online forms versus like calling phones? Like, is there any like broader trends that you've noticed?

Uriah Guilford:
There's usually a number of contact options that people have on their website. It's usually a form, a phone number, and maybe there's some other options there. My favorite is online scheduling so that the potential client can actually schedule a call with the therapist or with the intake coordinator to talk about their needs and talk about what kind of therapist they're looking for. So those are usually the options that most people put out there. And people preference of potential clients depends on so many different factors. Some younger people would prefer to text or just schedule online. And then a lot of people we've noticed in my practice still want to call. So it kind of it's across the spectrum. Yeah.

Melvin Varghese:
So I guess broadly, it probably is wise to offer different options until you've kind of gotten clarity of like, oh, this is where are like disproportionately these calls are coming from.

Uriah Guilford:
Yeah, my advice to practice owners, whether they're solo or group, is to choose the most ideal contact method for them and then highlight that. One of the mistakes I've seen on a lot of people's websites is that they give people too many options. So they're like, call us, text us, fill out this form, fax us. Here's our mailing address. Send us a mail. There's too many options. And I always like to, you know, when we're training our intake coordinator team at Productive Therapist, I always point out that when people are reaching out for therapy, they're in crisis, some level of crisis. It might be mild to moderate, but it might be severe. So they're not exactly in the best place to make difficult decisions. So choose one main option and guide them easily and tell them what to do so that they don't have to work too hard to figure it out.

Melvin Varghese:
Yeah. Right. And especially if someone, whatever level of crisis they're in, usually their mind is of like single focus, right? They're not able to sort of process like multiple things. And I would imagine like too many options would often lead to more overwhelm and then actually not making a call or going is clicking on somewhere else or, you know, trying to find some other options or something like that.

Uriah Guilford: Absolutely.
Yeah.

Melvin Varghese:
How would a solo practitioner know when it's time to consider hiring an intake coordinator?

Uriah Guilford:
Yeah, great question. So I actually created a quiz a little while ago for people to figure out if they're ready for an intake coordinator. So if folks want to go to ProductiveTherapist.com slash quiz, they can take that quiz. It's a good one. I would say, though, for most solo practices, they won't ever need an intake coordinator. That's my honest answer. even though that's one of our main services. If you're a solar practitioner, most likely you can use technology to automate or streamline most of that initial contact and the process of getting a client into your practice. EHRs, modern EHRs are fantastic. And online scheduling platforms are excellent. So if I was going to start a solo practice again today, I know you did that not too long ago. I have some very specific ideas about how I would do that. I would just go ahead and use simple practice and use the scheduling option in the client portal for people to schedule a 15 minute phone call. That's how I've always done it. And then I would talk to them and then if it was a good fit, set them up in my in my EHR and we'd be off to the races. And I would put that widget on my website so people could just click, see my availability and schedule. So that's what I would do if I was a solo practice at this point. No need for an intake coordinator.

Melvin Varghese:
I guess. Is there ever a scenario where a solo practitioner would need an intake coordinator?

Uriah Guilford:
Yes, actually. So my initial answer is no, you don't need an intake coordinator. But my follow up would be there are some solar practice owners that are incredibly busy, right? I'm sure you know some of these folks. They see 20, 30, 35 plus clients and or maybe they're a professor at a university and maybe they are doing coaching or they have a side business of some sort and they really do need somebody to kind of run point and manage their entire schedule. Maybe even do some sort of executive assistant kind of functions. So at Productive Therapist, we do provide virtual assistance for some solo practices and it tends to be those folks that have a very busy caseload or they have other things going on and they just need to hand off that part of their practice.

Melvin Varghese:
Turning to the other side, how would a group practitioner know when it's time?

Uriah Guilford:
Take my quiz. No. That's right. Yeah. So it's a difficult thing to figure out because when you're starting a group practice, when you're growing a group practice, you don't necessarily have a lot of free time or money. In the beginning, you might have a little bit more time than money. Most group practice owners wait too long to hire an intake coordinator. And what they usually end up doing is they hold that role for themselves. And I totally understand this because this was my story back in 2015. That's when I started my group practice, same year you started STC, I think, right? So I remember vividly, right next door to the office where I am right now, many nights a week, 9pm, kind of slouched in my chair, just finished a bunch of sessions with teenage boys and their families. I was exhausted, checking my email and seeing that new calls had come in and wanting desperately to connect those people with our services, but also being drained of my energy and realizing I just didn't, it was too late and I didn't have the time to do it. And then the next day I'd have to try to get back to them. Meanwhile, I was writing all the blog posts, doing the networking, managing our QuickBooks, you know, all of the things, yeah, that a group practice owner does. So my short answer is hire an intake coordinator as soon as you can. As soon as you can afford it, it's a good idea. It will help you grow so much.

Melvin Varghese:
It seems like any intake coordinators, in addition to like perhaps like a clinical coordinator, those seem like important like first hires for a group practitioner.

Uriah Guilford:
I would say intake coordinator first, most likely because the practice owner is likely going to be potentially the first clinical supervisor or the actual acting clinical director for a while until they grow enough to hire someone else into that role. And in my opinion, the intake coordinator is like the MVP, like they're one of the most important people in the practice. And so besides hiring clinicians for a group practice, obviously you can't have a group without another therapist. Intake coordinator is the way to go. Interestingly enough, I started working with virtual assistants back in 2012. So it was back in my days of solo practice. And I was very, very fortunate to work with an amazing woman named Gina and, uh, worked with her for five years and her role kind of developed over time. But eventually she was my intake coordinator. She was responding to new inquiries, setting them up in the HR, et cetera. And it was such a wonderful experience. And then unfortunately, she passed away from cancer. And it was really sad because we had worked together for so long. And this was pre, obviously way pre-pandemic. We never saw each other on video. We did everything over, basically over email. Yeah, it was amazing. So that was so sad. And then I was in the position of, you know, growing this group practice, and I just lost one of my most important support staff. And so that actually prompted me to start Productive Therapist to solve my problem of needing part-time administrative support and the rest is history.

Melvin Varghese:
That's amazing. Yeah. How did you, like Uriah, like make the shift in your mind of, I can handle these calls, I can respond to these calls too, I need to delegate this because long term, this is going to be the smart and strategic move, because I feel like a lot of clinicians struggle with this, which is, I mean, it's like the e-myth revisited, right? Most private practitioners are, are technicians, right? And so our natural tendency then is to try to do everything.

Uriah Guilford:
Yeah, it's really hard. It's, it's a very difficult thing to let go of. I mean, delegating in general is hard for any small business owner, but the intake coordinator role is so important. And when you're a solo practice or a new group practice owner, like it's really, it feels like you're so close to it. And it feels like you need to be that person talking to each and every client, making sure you guide them to the right therapist, to the right services. And if I bring in somebody else to do that, what if they do a really poor job? And what if people don't get the care that they need? And what if I don't know what's going on? There's so many what ifs. It's very difficult to let go of that. It was for me, certainly, because I thought, I thought to myself, I'm actually really good at this and I actually love doing it. I love talking to, you know, parents of teenagers and they're struggling, their family's struggling. Like this is why I do the work. Right. And so connecting them with the best therapist is like such a good feeling. So to let go of that was very, very hard, but I found somebody and hired them and I thought to myself, this is going to work out okay, but it's not going to be as good as it was when I was doing it. Right. The numbers wouldn't be as good. And, uh, I don't know if you know what I'm going to say here. You probably don't, but the results were better. my intake coordinator did better than me. And I was, I was, I was kind of shocked. So I never went back from there.

Melvin Varghese:
Yeah. It requires such a, I don't know, it's such a practical decision, but it's such a mental decision as well to like transition away and then like let go of these roles, you know, trusting that Yeah, in some situations it ends up better, but then like other situations it doesn't, but then the freedom, right? Like the freedom that you gain could be really beneficial to the mental bandwidth, right? I could imagine like, right, like that Uriah who's got like a full day of clients and then realizes how to return all these calls and then like how present or, you know, would it be like the next day where you're like, I got to return those calls. Wait, I have a full day. It's heavy. It is heavy. Yeah. What are like the top three responsibilities that you see for an intake coordinator?

Uriah Guilford:
Yeah, so mainly they're handling the initial client contact. They're scheduling the first appointment, setting that client up in the EHR. And then broadly they're handling general admin and client requests. Maybe the clients reach out and they need a super bill or they need to reschedule or other sorts of back office things, updating credit cards. So the role is primarily, um, you know, client facing for that initial contact and walking those people through the process. But then generally intake coordinators do a handful of other things that are very helpful to the practice, sort of on the administrative assistant side.

Melvin Varghese:
I love that you broke that down. So three things, handling the initial call, scheduling that initial appointment, and then general sort of catch all admin things to reschedule. I love particularly that you included that last one, because I could imagine that could be another way you could get like sucked right back in, into like coordinating all these things if you're having to handle reschedules, or even like provide super bills, all that kind of gets to be a lot.

Uriah Guilford:
Yeah, it really does. And then, I mean, depending on the practice, usually the person in that role, unless the practice is larger and they're truly just doing intake coordination, they're probably handling other tasks too. Like our virtual assistants will schedule social media posts. They will handle some of the basic billing tasks and other things like that. So if you hire a really good person, they likely can help you with other things too. So it can be a little bit broader or narrower as needed.

Melvin Varghese:
Yeah, so what I'm hearing is there may be times where it's like those three roles, like one is more highlighted than other times. And that's like really normal. And then I guess the other thing I hear is, there's probably going to be a little bit of a time where the person gets into a flow with your practice. So don't like be disheartened if it's like, not smooth sailing in the first like week or two or something like that.

Uriah Guilford:
It takes some time to get into a rhythm and a routine. And depending on whether or not the person you hire has done the intake coordinator job before, or if they just have some, you know, maybe they have a psychology background or something, or maybe an administrative assistant background, but they need to be trained on how to provide these services in a mental health setting. So you really have to spend time obviously hiring the right person and then giving them enough training so that they're really solid, they're ready to go before they even answer an email or respond to a phone call.

Melvin Varghese:
Speaking of which, what things should you have in place since client data is potentially being shared even at that onset? There may be situations where you've never even touched base with a client but they're talking to your intake coordinator and getting information.

Uriah Guilford:
Yeah, good question. Digital security and privacy obviously is very important. It always has been. It used to be so simple back in the day because we just had paper forms and we had voicemail. Like that was it, right? Yeah. My half thing, things have changed. So in less than a decade, right? Truly, truly. Like if you think 2015 to 2025 vastly different landscape for what we do with private practice. Yeah. So interesting. In any case, if the intake coordinator is a W-2 employee, you're basically covered by your employee handbook, and you should have things in there that relate to how sensitive data PHI is handled, and you should be covered by that. Obviously, you have to keep up with that and make sure that they're following those procedures. And then if you are working with a freelance virtual assistant or an agency, such as Productive Therapist, you just want to make sure that there's a business associates agreement in place, often called a BAA. And that just details exactly what the responsibilities are of that virtual assistant or the agency and how they will handle any sort of privacy breaches. So those are the two ways to go about that, whether it's an employee or essentially a contractor.

Melvin Varghese:
And then the other side of this, right? Like intake coordinators obviously aren't robots, right? So how do you handle things? Not yet. I know I hesitated on that question. I was like, cause you know, now being on LinkedIn, like there's somebody I followed, they're like, what do they call it? Humanoids, right? Like really? Yeah. And it's like fast. I'm like, so he'll like make a video and then there's like a robot walking in the background. I'm like, Yeah, but how do you handle things like if the intake coordinator is like sick or goes on vacation or something like that? I mean, is it just like looping somebody in or is it you take like, I don't know, I would love to hear how you think about that.

Uriah Guilford:
Yeah, a couple different solutions for that for a small to medium sized practice. likely the owner's gonna step in and just take over. That usually works out fine, unless there's some vacations that are overlapping. But in a larger practice, there's generally an intake team. So there might be multiple intake coordinators. And if that's not the case, one other solution, like a third solution, would be cross-training one of the clinicians in the practice to be able to step in and sort of cover for that vacation or that illness. Those are usually the things that most people do.

Melvin Varghese:
What are you defining? It's like a small to medium sized practice versus a large one?

Uriah Guilford:
It depends on, people can define that differently. I think five to 15 clinicians is small to medium and then large would be 20 plus.

Melvin Varghese:
Yeah. It's so interesting. I was thinking like the transition from like an agency to solo practitioner, there's like that transition from a solo practitioner to like a group practitioner. There's that transition. But then even within group practices, like there's transitions. There's step ups.

Uriah Guilford:
Yes.

Melvin Varghese:
As you add employees and different things. And even I was thinking, like if you are a group practice owner or like if you're a solo practitioner that's starting a group, but you're imagining at some point having like 25, 30 clinicians, there's wisdom in like thinking like, yeah, I'm going to eventually have an intake team. So how do I both simultaneously build this in the moment while potentially even cross training and working through like how a team can emerge as we concurrently get bigger versus like, oh gosh, now we need a team because we're so overwhelmed.

Uriah Guilford:
It can growth can happen fast at times. Right. And so this is one of the pain points that I see most often is kind of scaling the support staff with the group practice growing is a challenge. And I think that's where productive therapist honestly comes in clutch because we have a team of mental health trained, you know, HIPAA certified virtual assistants that can step in. And the practice owners don't need to do very much at all to get going with those services. So I think like if I was starting over again, I would absolutely do myself in the beginning. And then I would hire a mental health virtual assistant. And then the next sort of graduation, we've done this with many of our practices is going from a mental health virtual assistant to an in-house intake coordinator. Because once the practice gets to a certain size, it just makes sense to go ahead and pay a W-2 employee. But that's kind of the stepwise way to do it. I will say that there's a lot of like finding the right person to hire and then training them, like I mentioned before. it's actually really difficult. And then keeping them and retaining them for months and years to come and having that stability in the practice, it's hard. If anyone has ever done this, um, if you, even if you just put out a job application on or not application, but a posting on indeed for, you know, mental health virtual or mental health intake coordinator, you'll get hundreds of applications. And it's like, how do you pick the best one? It's So it's, it's not easy, but once you do find that person, you train them and you get them solidly in that position. It's an absolute game changer for the practice owner. It's huge.

Melvin Varghese:
Speaking of which, like what are some, again, I ask a lot of really basic questions, but like, what are some like best practices to like retain these intake coordinators? Cause I, I would think like the demand is quite high and especially for like well-trained ones. I mean, just like what are the, you've seen.

Uriah Guilford:
That's a good question. So I told you that I worked with Gina for five years and that was amazing, right? And then between Gina and Tiffany, I had a couple other intake coordinators that didn't stay super long. And then I worked with Tiffany for six years. So the last six years, Tiffany was providing those services to my practice. And I can't even tell you how much peace of mind and stability that brought to my practice. Now, how did I retain her? Well, I obviously treat her really, really well, pay her as well as I can, provide benefits, create not only a culture, but a practice where the systems are working smoothly so that there's not daily tension and frustration. So I think those are some of the things that come to mind. And yeah, if you give people a great place to work with meaningful things to do and people that they like talking to, they're likely going to stay.

Melvin Varghese:
Yeah. I'm glad you said that. I forgot exactly where, but literally this morning I read some government report saying that people's satisfaction with job places are at their lowest in a very long time. So I think it speaks to that desire to really create an environment where people want to stay and are valued. I have two questions for you. What do you think is the top mistake that you see therapists making when trying to hire an intake coordinator?

Uriah Guilford:
Ooh, the top mistake? Like the number one?

Melvin Varghese:
Yeah, like if I could only say one.

Uriah Guilford:
Not doing it soon enough. Yeah, I would go back to that. Not doing it soon enough. But if that was, let's say that's off the table, right? The biggest mistake that they make is not giving them enough training. Honestly, that would be the one because a busy practice owner, whether they're solo or group, they don't have a lot of time or bandwidth. So once they do the work, the heavy lift of finding that person and hiring them, it's so easy to just want to say, okay, uh, good luck. I hope it goes well. But most support staff in a mental health practice need a lot more training and support and coaching and mentorship than they get. So I would say providing enough training and support until they're really, really solid, and then you can step back.

Melvin Varghese:
Is there sort of a, I guess, a phased approach to that sort of training? So I eat like, you know, in the initial stages, like running through some mock scenarios and then having them do like a call where like you're looking over there, you're with them. Like, how do you sort of think about it and approach it?

Uriah Guilford:
Yeah, there's a couple of different things that you can do. So when I was training my first intake coordinator, they were actually in this office that I'm in right now in this space, we actually recorded some calls. and with permission from the person on the phone, obviously. We recorded some calls so that then I could listen to them and give him feedback. That's incredibly valuable. It's a little bit harder to do because it's sensitive and people don't necessarily want to consent to that. That's like the absolute best way to do it. The secondary was sometimes I would come in and I would listen to him on the phone while he was talking to a potential client. And then I would, then we would talk afterwards and I would give him some feedback. If it's virtual, you would have to record the call or just, you know, have a meeting after one or two intake calls and then kind of talk through it. And of course you can do role plays and those kinds of things as well.

Melvin Varghese:
Awesome. Uriah, the final question I have for you is, are there any metrics that either a solo or group practitioner should look at to determine like whether an intake coordinator is worth it? So for example, you know, we've noticed like the number of folks calling to actually scheduling is increased by 25% or whatever it is.

Uriah Guilford:
Yeah. Two metrics I would highlight. The first one is owner freedom, and that's a little bit harder to categorize. One of our sayings is that we help therapists get more done so they can have more fun. And when I was getting my first virtual assistant, my business coach at the time said, well, what are you going to do with the time that you save, whether it's five or 10 hours a week? And if you're going to use that time either for enjoying your family, your hobbies, or growing your business, then great. So owner freedom is number one, but the second one really is your conversion rates. And that's just like terminology that means how many clients reach out and then how many become new clients. So your intake coordinator should do as well as you or hopefully better over time. So you want that. And that's going to happen with more availability and a quicker response time. Um, and of course the right person. So you want to keep a track, keep a track on that.

Melvin Varghese:
That's awesome. Uh, is there any sort of, I guess this could really vary by niches and populations, but is there sort of a standard number? Like, you know, you're doing really well if you know, 50% or 60% of your calls are converting or anything like that at all.

Uriah Guilford:
It's a little bit hard to get anything solid on that, but it seems like private pay practices tend to be a little bit lower, because insurance practices, it's easier for those people to say yes, because if I call and you take my insurance, easy, and you have availability, easy. So insurance-based practices usually are between 40 to 60, sometimes higher, 80 or higher, and then private pay practices are usually in the range of 20 to 40%. I think my private pay practice got up to about 45, 50%, sometimes a little bit higher. Yeah, I don't know if that's helpful, but those are kind of the ranges.

Melvin Varghese:
Yeah, it's so interesting. I feel like we almost need to do another episode on conversion of a private pay practice for an intake coordinator. It'd be so interesting. You're doing so much awesome stuff in the world. You've got a course as well to support therapists if they want to get their feet wet and think through this. Please do take a moment to tell us about the course and also how we can learn more about the awesome stuff you're doing in the world.

Uriah Guilford:
Definitely. Thanks. I appreciate that. So everything, all of our resources are at ProductiveTherapist.com and we do have a course called the Intake Hiring Starter Pack. And essentially we just took all of our best practices from hiring over a hundred intake coordinators which is a lot. And we put them into a course to kind of walk people through sort of a do-it-yourself process of, you know, recruiting and hiring an intake coordinator. So I'm really proud of that course. And my team, I'm not involved in hiring anymore. My team does all the hiring. And so I brought them in to help create that course. And so these are best practices on how to do all the things you need to do.

Melvin Varghese:
Yeah, that's awesome. And, uh, you are so kind to give the STC community a little discount as well.

Uriah Guilford:
Absolutely.

Melvin Varghese:
On the course. And so, uh, I believe the discount code is STC. Right.

Uriah Guilford:
Keep it simple. STC will give you 25% off that course. Yeah.

Melvin Varghese:
Perfect. You're right. Thank you again. I really am just so grateful for you. I'm glad that, you know, LinkedIn has enabled us to reconnect and grateful for all the work that you're doing in the world.

Uriah Guilford:
Thanks Melvin, appreciate it.

Melvin Varghese:
All right. Have a great rest of your day. Hey everyone. I hope you enjoyed my conversation with Uriah and especially if you are in a season where you considering an intake coordinator, or if you have an intake coordinator and you've just been struggling with how to best maximize their potential. I hope that today's podcast session has just been incredibly helpful for you and yeah has just given you some new ideas in terms of how to approach it. As I was talking with Uriah and I was just reflecting on this idea of how an intake coordinator is really like the symbolism of like working in our business versus on our business. and how it's this transition of when we realize that we can't do all of the things in order for our private practice to succeed and then even like a hard realization that we may be the handicap or the roadblock that's holding our practice from where it should be. The STC equivalent of this has been for me is like hiring an executive assistant because, you know, Mel left to his own devices. We'll try to do everything possible with STC and do all of the things because who else can do it better than Mel, right? But, you know, wiser Mel has coming to realize that there is something in letting things go and hiring out and hiring and asking for help. because at the end of the day, people can often do this better than I can. And then more importantly, or at least equally importantly, it frees up time to be able for us to do the work that we're the most gifted at. And so I think in terms of private practice, it's often serving your clients well, learning and getting versed in theoretical orientations and getting to be a better clinician. Uriah mentioned that they have an Intake Hiring Starter Pack. So if you go through sellingthecouch.com forward slash intakehiring sellingthecouch.com forward slash intakehiring and enter the promo code STC, you get 25% off of that course if that's something that would be helpful for you on your private practice journey. Have a great rest of your day and I will see you next time. Bye!

Narrator:
Thanks for listening to the Selling the Couch podcast. For more great content and to stay up to date, visit www.sellingthecouch.com.

Melvin Varghese:
Hey, it's Melvin. I hope that you're enjoying today's podcast session. Just wanted to also let you know that STC Elite, our mastermind for therapist course creators, is now open for enrollment. If you've been thinking about creating an online course, and specifically if 2025 is the year that you want to create your online course, definitely encourage you to check out our mastermind. It's over at sellingthecouch.com forward slash mastermind. We launched this back in 2021 and since then over 60 of our colleagues have gone through our mastermind. It includes a ton of support all the way from live teaching, live feedback from colleagues and from our team to build out and structure your online course all the way to mindset coaching, all the way to access to our video editing and graphic design team so that you don't have to hire everything separately. We've made it really super comprehensive and I think you're really going to enjoy it. Again, the link is over at sellingthecouch.com forward slash mastermind. Enrollment does wrap up at the end of August. So definitely encourage you to check it out and consider joining us. And again, we have a free email course. It's seven days. It'll help validate your course idea. I know that's the biggest struggle many of us are navigating of whether the course is actually going to make money. And we put all of this into a simple to understand email course that you can check out over at sellingthecouch.com forward slash course kit, sellingthecouch.com forward slash course kit. We'll jump right back into today's session. Hey there, thank you so much for tuning in to today's session. Just wanted to also let you know that we have a free email newsletter that goes out every week. You can download it over at sellingthecouch.com forward slash newsletter. Basically that newsletter contains some of the stuff that's happening behind the scenes with STC and also with my life and how I'm balancing and trying to balance being both an entrepreneur as well as building a life around my family and my health as well. And it also contains the latest podcast episode and some of the stuff that I'm doing on LinkedIn, some of the strategies and things that are working for me. And then finally, a brand new section called On Mel's Mind, where I take a video or a book or a blog post or something like that, that's inspiring me for that week. And I share how I'm implementing it both in my life and in my business. Again, you can download that over at signthecouch.com forward slash newsletter. And if you are one of the 3,700 colleagues that have been a part of the email newsletter, I so appreciate you and I'm grateful for your support. We genuinely try to make these helpful and just based on the data and based on the feedback we're getting, it seems like we're doing a really good job. So appreciate you and I hope that you have a great day.

timestamps00:03:36 – Introduction to the Episode and Guest
00:05:23 – Defining an Intake Coordinator
00:06:40 – Challenges in the Client Intake Process
00:10:27 – When to Consider Hiring an Intake Coordinator (Solo Practitioners)
00:12:34 – When Group Practitioners Should Hire an Intake Coordinator
00:19:10 – Key Responsibilities of an Intake Coordinator
00:27:14 – Best Practices for Retaining Intake Coordinators
00:31:03 – Metrics to Evaluate the Effectiveness of an Intake Coordinator
00:33:05 – Introduction to the Intake Hiring Starter Pack Course
00:34:11 – Conclusion and Reflection on the Episode

selling the couch podcast with melvin varghese phdWeekly interviews, strategy, and advice for building your private practice in and beyond the therapy room.

Apple podcastsYou TubeSpotify ready to launch your podcast?Please check out our FREE podcasting workshop for therapists (and therapists turned coaches and consultants).

This workshop is pre-recorded so you can watch it on a day and time that works for your schedule.

It contains a lot of practical tips that we've learned as STC has reached 1.81 million+ downloads and become a 6-figure business with podcasting as the backbone.

Uriah Guilford is a group practice owner based in northern California. He also owns Productive Therapist, which provides virtual assistants and intake coordinators for therapy practices. Uriah has been a group practice owner since 2015 and has a lot of wisdom to share about the journey to hire and train an intake coordinator.

Melvin varghese phdPsychologist and Founder @ Selling The Couch

Melvin Varghese, PhD is a licensed psychologist in Philadelphia, PA. In 2015, Dr. Varghese founded Selling The Couch, a podcast to help therapists move from clinical to online income.

More PostsUncomfortable Truths About Private Practice Finances (with James Childress)by Melvin Varghese | Jan 24, 2025 | Blog, Private Practice, STC Podcast

Melvin Varghese with James Childress on Uncomfortable Private Practice Finance Truths

When Should You Hire An Intake Coordinator? (Uriah Guilford)by Melvin Varghese | Feb 6, 2025 | Blog, Growing Your Practice, Private Practice, Productivity, STC Podcast

Uriah Guildford joins us to talk about hiring an intake coordinator.

5 Signs You're Ready To Launch Your Online Courses (with Melvin Varghese))by Melvin Varghese | Jan 31, 2025 | Blog, Online Courses, Passive Income for Therapists, Private Practice, STC Podcast

Melvin Varghese giving an overview of launching successful online courses and how you know you are ready.

« Older Entries The post When Should You Hire An Intake Coordinator? (Uriah Guilford) appeared first on Selling The Couch | Melvin Varghese PhD.

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383: 5 Signs You're Ready To Launch Your Online CourseWritten By Melvin Varghese PhD5 Clear Signs You’re Ready to Launch an Online Course as a TherapistHave you ever thought about creating an online course but felt unsure if now is the right time? Maybe you’ve been stuck wondering:

• Do I really know enough to teach?

• Will anyone even buy my course?

• What if I spend all this time and it flops?

If any of this sounds familiar, you’re not alone. I had the same thoughts back in 2015 when I was still deep in clinical work. I had just launched my podcast, and colleagues started asking me for podcasting advice. The more questions I got, the more I realized—I could put this knowledge into a course instead of answering the same things over and over.

That course became Healthcasters, which has helped 244+ therapists start their own podcasts. And guess what? I didn’t feel 100% “ready” when I started either. But readiness isn’t about having it all figured out. It’s about taking the first step and figuring it out along the way.

So how do you know if you’re ready to launch your first online course? Here are 5 key signs to look for.

1️⃣ You Want to Make a Bigger Impact

Therapy is meaningful, but it has limits—you can only see so many clients in a day. If you’ve ever thought, I wish I could help more people without adding more hours to my schedule, then a course could be the perfect next step. It's a completely different model because most therapists (including me) are taught that the only way to make income is to “trade dollars for hours.”

But a well-structured online course allows you to:

✅ Teach once, impact many

✅ Serve people beyond your local area

✅ Create a scalable income stream that doesn’t depend on 1:1 sessions

2️⃣ You’ve Mastered a Specific Skill (and People Ask You About It)

If clients (or even colleagues) regularly seek your expertise in a particular area, that’s a great indicator that your knowledge is valuable.

Think about what you’re already known for in private practice:

• Do you specialize in DBT for teens?

• Are you the go-to therapist for high-achieving professionals with anxiety?

• Have you found a unique way to blend IFS and EMDR?

If people are paying you for your expertise in therapy, they’ll pay to learn from you in a course too. Btw, this is a helpful video on finding a niche as a therapist and why it's important.

3️⃣ You Have a Passion for Teaching

If you love explaining concepts to clients, supervising interns, or leading workshops, then creating an online course might feel like a natural fit.

And no, you don’t need to be a “traditional” teacher. Your unique voice and approach will resonate with the right people. Some learners will prefer your teaching style over someone else’s—and that’s why there’s room for your course in the market.

4️⃣ You’re Open to Learning New Skills

Creating an online course isn’t just about teaching—it’s also about learning. You’ll need to pick up a few skills, like:

🎥 Basic video recording & editing

📢 Marketing your course (without feeling salesy)

🖥️ Choosing a course platform (we like, use, and recommend Kartra; free trial through this link for STC fans)

The good news? You don’t need to know everything before you start.

I had zero experience in online business when I launched my first course. But I took small, steady steps—and you can too.

5️⃣ You’re Willing to Validate Your Idea Before Building

The #1 mistake I see therapists make? Spending months building a course before testing demand.

You don’t need a polished course to get started—you just need proof that people want what you’re offering. That’s why we created the Course Creator Starter Kit—a free 7-day email course that walks you through how to validate your idea before you build.

✅ Get real feedback before you spend months creating

✅ Avoid launching a course no one buys

✅ Save time, energy, and money

💡 Sign up here → CourseCreatorStarterKit.com

Final Thoughts: Are You Ready?

If you checked YES to even one of these signs, you’re likely more ready than you think. The key is to start small and let quiet compounding happen.

You don’t need to build an 8-module, high-production course overnight. Just validate your idea, create a minimum viable version, and refine as you go.

Ready to take the first step? Sign up for our free 7-day email course to validate your course idea before you build. It’s the same process I used to grow Healthcasters into a $328,000+ course.

🎯 Join the Course Creator Starter Kit now

If you’re a solo therapist considering taking some (to hedge) or full insurance but want to skip the headaches of dealing with insurance companies, Alma is worth checking out.

With Alma, you’ll benefit from:

• A 45-day credentialing process (no more months of waiting!)

• A HIPAA-compliant telehealth platform to keep your sessions secure

• Guaranteed payouts every two weeks

• Access to CEUs included with membership

Alma makes it easier than ever to build a thriving practice.

👉 Learn more and get 2 months FREE—an exclusive offer for STC listeners

We'll jump right into today's session. Hello, hello. Welcome to today's session of Selling the Couch. If you have been thinking about creating an online course, but you are struggling with whether you are ready to create an online course, then today's session is for you. We're exploring five areas and five questions or five indicators that can let you know whether you are ready to launch an online course. I remember when I first started or had the idea for a podcasting course. This was around June of 2015. The kind of interesting thing was I had just launched the STC podcast in March of 2015. So it wasn't like, and I had been learning about podcasting maybe since like September of that previous year. So I very much did not feel like I was an expert on podcasting.

At a practical level for me, I was deeply rooted on the clinical side at that time as well, so I was still at a group practice where I was doing individual and couples therapy, I was doing bariatric surgery psych evals, and then I was also working at a community mental health agency doing biopsychosocial evals. And when I launched the STC podcast in 2015, what started happening is colleagues started emailing me or they would DM me on Facebook and ask if they could console with me on doing this podcasting thing. I didn't know how much to charge, so I was like, let me just charge as much as I'm making on one of these biopsychosocial evals, which was a paltry $200 for several hours of work. But I was like, I just want to replace that income and then see if I can have some options there. As more and more colleagues started reaching out to do these consults, I was like, I wonder if we can present this information in an online course format.

But the idea of honestly launching an online course and teaching, especially in an online medium, at that point I was honestly about three years licensed as a psychologist, so I was still in my early 30s, and I very much felt like I didn't want to step on anyone's toes. I felt like, who am I to be teaching when I myself have done podcasting for less than a year? And then I also worried about, what if nobody signs up? And those fears really crippled me. But here's what I learned. Readiness isn't about having it all figured out. It's about taking that first step with intention, knowing that the dots will connect at some point. You just have to take those first steps. So how do you know if you are ready to create an online course? So the first sign is you're looking for scalable impact. Therapy is meaningful. I love the work of therapy. We do amazing work in the therapy room. It serves others really well. But the model in private practice is the therapy model in itself is about trading time for income, right?

So you see a client for a clinical hour, you get paid. If you don't see a clinical hour, you don't get paid. Now, if you've ever thought, I want to help more people without sacrificing all my time, creating an online course could be for you. It basically allows you to share your message on a bigger scale beyond and grow your impact and your income beyond the therapy room. The second sign that you are ready to launch an online course is you've mastered a specific skill or you have a very specific niche that you are known for. So think about what you are getting known for and think about the niches and specialties that you are getting known for. If you have a certain area and folks are coming to you, they're paying for you for therapy, then it's usually a pretty good indicator that there's some potential beyond the geographic area that you are serving clients in, in order to be able to serve them. And so it seems like a very basic and kind of common sense thing, but what I notice is there's a segment of colleagues who usually start private practices and have not quite found a niche and they then jump into creating an online course thinking that somehow the online course will help them to expand or clarify what their niche is.

Personally for me, I actually feel that is backwards. So I actually feel like you should be in private practice for several years. I like to use roughly like five years of doing clinical work and getting known in a certain area. That way you already know also like the nuances of their pains and struggles. And that is when I would say then really consider creating an online course. You know, as therapists, we manage so many roles in private practice, from being a clinician to a business owner, to doing all the things that we need to do to market our practice. It's really easy for all of us to feel overwhelmed, especially when we are juggling so many things.

That's where the team at Alma comes in. This is a platform that I would consider if you are a solo practitioner that is either wants to take insurance or that is private pay but just wants to hedge a little bit especially to account for periods of economic uncertainty or weird things like hyperinflation like we've been dealing with in more recent times. Alma makes it easier than ever to build a thriving private practice. They include a bunch of different cool stuff. So one is they have a members-only platform where you can exchange resources with other clinicians, exchange referrals, and just find support. They have consultation groups as well. And they also offer CEUs as part of your membership at no additional cost. These are both live and on demand. Now in order to get credentialed with Alma, typically to get credentialed with insurance it takes months and months, but Alma actually has a 45-day credentialing process and you actually get increased reimbursement rates. So they're often higher than if you were to go just through the insurance carrier and if you were just apply as a solo practitioner. And the really cool thing is they guarantee payback within two weeks of when you see the client so that you can ensure your income stays steady. You can see as few as like one client or two clients just to hedge a little bit. And Alma also has a HIPAA compliant telehealth platform so that everything is safe and secure. Alma also has a bunch of different stuff to support clinicians, all the way from workshops and all sorts of things, as well as an online directory, so that you can continue to get referrals coming your way. The best part, the team at Alma was able to hook the Selling the Couch family and listeners with a unique code, which is over at sellingthecouch.com forward slash Alma. That's actually for two months absolutely free on Alma's platform. This is a non-advertised, like non-publicly advertised discount. So definitely encourage you to check it out over at sellingthecouch.com/Alma for a 60 day free trial just to see if it makes sense for you.

The third thing is you just have a passion for teaching. And because at the core of it, an online course is about sharing information. But I think of it as you are both, I call it an infotainer. So you're providing information, but you're also doing it in an entertaining sort of way. I tell our colleagues all the time when I say the word entertainer, it sounds like you're like juggling balls in the air while teaching a lesson or anything like that. It's more, can you, does the topic that you are creating a course on, does it light you up in a way that you are like, hey, I want to be able to teach it in this way or in this unique and interesting way. If that's something that you're like, oh yeah, no, I can definitely see that, then I think it's definitely usually an indicator that you're ready. There's also another kind of nuance. If you've ever enjoyed mentoring supervisees or leading workshops or explaining concepts, if you ever did any adjunct teaching or if you were in grad school, if you were a TA or anything like that, I think an online course is a natural extension of what you may love to do. To be honest, I never actually considered myself a teacher, even though I knew my grandparents were teachers, my parents were teachers at one point in their lives, and I knew that I had the skill sets and I knew that maybe there was something that I had been modeled as well. but I didn't really consider myself like a teacher and I think part of it was I just felt like, I don't know, I think I struggled a lot to be honest with like feeling like an imposter and feeling like even thinking like oh there's like I've had some really amazing teachers like how can I measure up to them but the reality is Each of us have our own giftings, our own ways of presenting. Even stuff, you know, that I share on the podcast, the reality is it resonates with a segment of our colleagues and it's not going to resonate with a segment of our colleagues. And that's okay. Your teaching and your approach as a course creator is not going to resonate with everyone. But the most important thing is that it resonates with a specific type of person. The fourth thing that I would say is you're open to learning new skills. So creating an online course isn't just about teaching, it's about embracing a bunch of different things like learning course platforms or learning how to grow an audience online, or learning some basic tech. Not like when you first create an online course you don't have to have some crazy fancy DSLR and lighting like I do now. Like a webcam with a halfway decent mic is more than enough. But as long as you have a openness and a heart to learn those tools and to say like, hey, you know, these are things that I think I could see myself developing over time is the key. You know, the reality is you don't have have to be an expert right when you're starting with all of this stuff, like building an audience and all of this. But you just have to have, I think what I've learned is just a willingness and a heart to learn. I personally, on my end, I didn't take like business or marketing classes in undergrad or grad school. I had zero experience in online business. But what I learned is just along the way, just taking these like small iterative steps is kind of the key and the most important thing. The fifth and final point is you are willing to validate your idea. Now this seems like a very basic but it's an important step because I personally feel like every therapist has an online course within them because if you think about it, we are building private practices or coaching or consulting and we're getting known for something. And so because we're getting known for something, inevitably that also means that we have expertise in an area and we can teach that to other people. Now, the most important thing, though, is just because you are passionate about a course topic doesn't mean that people will actually buy it. So you don't need to have a polished course to start. You just need to know that there's an audience for your idea. We created a free 7-day email course that's specifically built for therapists who want to create an online course to help them validate and test their course idea. You can learn more about it at sellingthecouch.com forward slash coursekit sellingthecouch.com forward slash coursekit or you can go to coursecreatorstarterkit.com But just taking the time to validate your idea, because often what I learned is it's not just about the online course, right, like the digital course, it's about all of these other opportunities that can springboard from the course. So for example, and again, this all depends on what you want to do and how you want to do it, but Let's say that you also want to do live trainings for the course. You just want to take the time on the front end to make sure that there's income potential and there's audience potential for your course. Otherwise what's going to happen is you will end up spending a lot of time and energy trying to get into a course idea that may not actually have demand. So I know this is a little bit shorter episode than usual, but I wanted to stick, you know, get straight to the point. But the five points basically are how do you know you're ready to create an online course? You're looking for scalable impact. So in your heart, you have felt like you have a bigger mission to share. And that mission, you love the therapy room, but there's somehow just the therapy room feels confining in some sort of way. The second thing is you've mastered a specific skill or a knowledge area or a specific niche, and that you're becoming a known expert in that niche. The third one, you have a passion for teaching, sharing what you have learned along the way to a new generation. And this is the other nuance of it, is you're not trying to often create a course for everybody, even for somebody that may be on the same level as you, or even more advanced from you. You're actually trying to often create a course for somebody that's two to three steps behind you. The fourth point is you're open to learning new skills and so often an online course is not just about creating the course. It's about things like learning to build an audience and knowing what course platforms to pick or learning some of this gear when it comes to recording an online course. It's a lot of fun trying to figure it out and you definitely don't need to put all this pressure on yourself to try to have it all figured out in year one. It's just about being willing to stay for many years and saying, hey, I think I would really enjoy this and I want to get better and better at it. And the fifth point is again, you're willing to validate your idea. Again, I just wanted to like double click and emphasize that because I've seen so many colleagues who have wonderful course ideas, but there is an actual market demand for them and I would never want you to create an online course if it actually wasn't going to be, if we can't reasonably say it's going to be successful. Again, our course creator starter kit is over at sellingthecouch.com forward slash course kit or you can go to course creator starter kit dot com. Have a great rest of your day and I will see you next time. Bye.

Narrator: Thanks for listening to the Selling the Couch podcast. For more great content and to stay up to date, visit www.sellingthecouch.com.

Melvin Varghese: Hey there, thank you so much for tuning in to today's session. Just wanted to also let you know that we have a free email newsletter that goes out every week. You can download it over at sellingthecouch.com forward slash newsletter. Basically that newsletter contains some of the stuff that's happening behind the scenes with STC and also with my life and how I'm balancing and trying to balance being both an entrepreneur as well as building a life around my family and my health as well. And it also contains the latest podcast episode and some of the stuff that I'm doing on LinkedIn, some of the strategies and things that are working for me. And then finally, a brand new section called On Mel's Mind, where I take a video or a book or a blog post or something like that that's inspiring me for that week, and I share how I'm implementing it both in my life and in my business. Again, you can download that over at signthecouch.com forward slash newsletter. And if you are one of the thirty seven hundred colleagues that have been a part of the email newsletter is so appreciate you and I'm grateful for your support. We genuinely try to make these helpful and and just based on the data and based on the feedback we're getting, it seems like we're doing a really good job. So appreciate you. And I hope they have a great day.

timestamps00:00:00 – Introduction to Online Courses
00:02:40 – Sign 1: Looking for Scalable Impact
00:03:43 – Sign 2: Mastering a Specific Skill or Niche
00:05:09 – Sign 3: Passion for Teaching
00:07:23 – Sign 4: Openness to Learning New Skills
00:09:23 – Sign 5: Willingness to Validate Your Idea
00:12:54 – Recap of Key Points
00:14:29 – Closing Remarks and Resources

selling the couch podcast with melvin varghese phdWeekly interviews, strategy, and advice for building your private practice in and beyond the therapy room.

Apple podcastsYou TubeSpotify Melvin varghese phdPsychologist and Founder @ Selling The Couch

Melvin Varghese, PhD is a licensed psychologist in Philadelphia, PA. In 2015, Dr. Varghese founded Selling The Couch, a podcast to help therapists move from clinical to online income.

More PostsUncomfortable Truths About Private Practice Finances (with James Childress)by Melvin Varghese | Jan 24, 2025 | Blog, Private Practice, STC Podcast

Melvin Varghese with James Childress on Uncomfortable Private Practice Finance Truths

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Uriah Guildford joins us to talk about hiring an intake coordinator.

5 Signs You're Ready To Launch Your Online Courses (with Melvin Varghese))by Melvin Varghese | Jan 31, 2025 | Blog, Online Courses, Passive Income for Therapists, Private Practice, STC Podcast

Melvin Varghese giving an overview of launching successful online courses and how you know you are ready.

« Older Entries The post 5 Signs You’re Ready To Launch Your Online Courses (with Melvin Varghese)) appeared first on Selling The Couch | Melvin Varghese PhD.

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382: Uncomfortable Truths About Private Practice FinancesWritten By Melvin Varghese PhDThe Uncomfortable Truths About Private Practice Finances (And How to Fix Them)

Private practice can feel like the golden ticket for therapists looking for more freedom and flexibility. But the reality? It comes with challenges—especially when it comes to money.

Many clinicians assume that once they launch, clients will roll in, and everything will run smoothly. But as I’ve learned over the past 10 years of entrepreneurship, that’s not always the case.

I recently sat down with James Childress, a CPA who works primarily with therapists, to talk about the biggest financial mistakes private practice owners make—and how to build a practice that lasts.

Let’s dive into three uncomfortable truths about private practice finances (and how you can avoid these pitfalls).

1️⃣ There’s a “Danger Zone” for Group Practices

If you own (or are thinking about starting) a group practice, this one’s for you.

James pointed out something fascinating: there’s a size of group practice that’s inherently unstable.

🔹 What does that mean?

At this stage, a practice has too many clinicians to function like a solo practice but not enough revenue to fully support administrative staff. The result? Everyone feels stretched thin.

🔹 What happens when a practice stays in this stage?

• The owner gets overwhelmed trying to do everything.

• Clinicians struggle because the practice lacks strong leadership and support.

• Clients leave because things feel disorganized.

🔹 How do you fix this?

If you’re growing, grow with intention. Before hiring more admin staff, ask:

• Do we have enough revenue to support this role?

• Can we streamline operations before adding another hire?

• Are we balancing clinician needs with financial sustainability?

James sees many practices overstaffing on the admin side, which eats into profits. Instead of adding new hires, look into automation tools and outsourcing options to increase efficiency.

2️⃣ Seasonality Can Make or Break Your Practice

Most therapists don’t realize how seasonal private practice is until they experience their first slow season.

🔹 Here’s what you need to know:

• January–May → High demand as people start the year fresh.

• Summer (June–August) → Many clients pause therapy for vacations.

• Fall (September–November) → Another spike in new clients.

• December → Can be slow due to holiday travel.

If you launch at the wrong time, it can be tough to build momentum.

🔹 How do you protect yourself?

✅ If you’re starting out, time your launch when demand is highest (January–May or September).

✅ If you’re established, build a financial cushion for slower months.

✅ If you want to scale, consider launching a digital product that generates income year-round.

📌 Want a way to create income that’s not tied to client sessions? Sign up for our free 7-day email course to validate your online course idea.

3️⃣ Therapists Must Think Like Business Owners

James brought up a truth that many therapists don’t like to hear:

🔹 Private practice isn’t just about helping people—it’s a business.

If you don’t have a clear plan for growth, financial stability, and work-life balance, your practice can quickly feel like it owns you instead of the other way around.

🔹 How do you build a practice that lasts?

✅ Know your numbers. Track your expenses, revenue, and profit margins.

✅ Think long-term. Have a plan for growth that doesn’t lead to burnout.

✅ Make sure your business model works. Are you relying only on client sessions, or do you have other income streams?

Therapists who succeed long-term are the ones who embrace the business side of private practice. If you want to have more freedom and flexibility, you need to think beyond 1:1 work.

💡 Check out James’s firm to get expert guidance on your private practice finances.

Final Thoughts

Building a financially healthy private practice takes strategy and patience. The key takeaways?

✅ Avoid the “danger zone” in group practice growth—don’t scale too fast without financial stability.

✅ Plan for seasonality so you’re not caught off guard by slow months.

✅ Think like a business owner—your income depends on the decisions you make today.

If you’re a solo therapist considering taking some (to hedge) or full insurance but want to skip the headaches of dealing with insurance companies, Alma is worth checking out.

With Alma, you’ll benefit from:

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Transcript (AI-Generated)Melvin Varghese:
Hey it's Melvin. Before we jump into today's podcast session just wanted to take a moment to thank the team over at Alma for supporting today's podcast session. Alma is an all-in-one platform that works with solo practitioners particularly who want to take insurance but don't want to deal with all of the headaches of taking insurance. We know that as clinicians doing private practice, that managing all of the different facets of private practice is absolutely overwhelming. Everything from managing clients to the admin to the billing, it's not just seeing the clients, right? It's all the other stuff. And so Alma is an all-in-one platform that really makes this process a lot easier. Their core thing is that they let you get credentialed with a majority of insurance providers. They do a 45-day credentialing process. They offer higher reimbursement rates than if you were to go through just solo and apply for insurance. And they also do guaranteed payback within two weeks. So basically your income stays steady. You get paid within 14 days of actually seeing the client. Now where Alma really shines is actually beyond all of this, the other stuff that they do. So they offer everything from peer supervision groups to resource sharing groups where clinicians can exchange worksheets and all sorts of stuff, as well as live CEUs and on-demand CEUs so you can get your CU hours. They also provide a HIPAA compliant telehealth platform so you can see clients and do telehealth sessions without worrying about safety and security and all of those things. The team at Alma hooked Selling the Couch listeners with a special code two months absolutely free. This is not even advertised online, but if you go to sellingthecouch.com forward slash Alma, Alma is spelled A-L-M-A, you get two months absolutely free. Again, that's sellingthecouch.com forward slash Alma. We'll jump right into today's session. Hello, hello, welcome to today's session of Selling the Couch. I hope you're doing well, having an incredible day. I'm recording this in mid-December 2024, so we're getting ready for the holiday season and I'm going to be taking, you know, a couple of weeks off actually from STC. We've got some travel planned, mainly just kind of focusing on self-care and rest and got our online course mastermind launch that's happening from mid-January to mid-February. So our next cohort of colleagues who will be creating their online courses. So if you're interested in that definitely keep a eye out whether it's connect with me on LinkedIn or joining our newsletter which is over at sellingthecouch.com forward slash newsletter. But today's podcast is the topic is uncomfortable truths about private practice finances This is an episode that I've been wanting to do for a long time and it's mainly because I feel like sometimes in the private practice space private practice is often seen as this like golden goose that if you just get into private practice it's going to be great everything's going to be great like everything's going to be nice and smooth and with stc so one of the things that i have now learned that doing this for nine years which is crazy 10 years when it'll be year 10 when this episode releases and uh i just realized man there's a There's a lot more nuances there than that. Everything is not always like amazing, that businesses don't always just keep going up, that there are things that are like legit stressful. And I'm joined today by James Childers. James and I actually connected this year at the Mental Health Marketing Conference. And James is a CPA by profession. His website is cacadvisors.com. Most, if not all of his practice is focused on working with therapists. And so James has such an interesting perspective on private practice, but from a numbers perspective, and that's what we're talking about. And so we cover a range of things, but like kind of a bookend to it is I asked James to kind of share the top three emerging trends or the uncomfortable aspects of private practice. So, for example, one of them, I'll just share one of them, which is making sure that the external environment of your private practice matches the internal environment. So, this is both in terms of like how your practice is getting built out but also the internal of what structures are there internally for you like emotionally but also internally within your private practice to be able to accommodate that growth. Often I think what happens is for clinicians is they have this unexpected growth and they realize they don't have the infrastructure or the systems to be able to handle that growth and that inevitably then leads to burnout or resentment or just not doing as good work or if you're in a group practice like high turnover among clinicians. If you're in a solo practice maybe more clients like don't show up or they discontinue with you. I think you're going to really enjoy this conversation. I think it's going to open your eyes to to some of the realities of business ownership and private practice. So here's my conversation with James Childress from cacadvisors.com. Hey James, welcome to Selling the Couch.

James Childress:
Oh, thanks Melvin for having me. Appreciate it.

Melvin Varghese:
First of all, I'm so glad like we finally got to meet at Mental Health Marketing Conference and this year I like thoroughly enjoyed our lunch. That was some good tacos.

James Childress:
No doubt.

Melvin Varghese:
Puffy taco, which I've never actually heard of.

James Childress:
Yeah, that place was awesome. That venue for the conference was exceptional. Because I mean, there was food everywhere. But then good food. Yeah. So that taco place was awesome.

Melvin Varghese:
Yeah, if y'all listening, it's the factory in Franklin, Tennessee, shout out to them. And I liked it because it's almost like a conference venue, a coffee shop and like a restaurant scene or like a we work like combined together, basically. And it was such a cool vibe. And I loved it, because you could like totally go to the session, but you could step out and just like, grab coffee or grab a meal with somebody. And we got to do that. I'm so thankful for that. We're talking about something I had told you all night. I was like, I think I want to do something called Uncomfortable Truths About Private Practice Finances. And I thought, just based on our conversation, you're a CPA by training and you work with a lot of private practices, solo practices, group practices. And I feel like we've never done an episode where it's just like talking about the numbers, but not like in a, this is going to be a horrible episode. What are like profit margins in private practice? What are things that therapists don't talk about that kind of stuff? So I'm really looking forward to like our conversation and, uh, yeah, I appreciate you.

James Childress:
Yeah. I'm excited. Yeah. Let's dig in.

Melvin Varghese:
I don't know, when I was thinking about this, like, I told you, like, hey, let's maybe think about like, kind of top three interesting things that therapists don't talk about. But even before we jump too much into that, I feel like broadly, I feel like a lot of many therapists go from a traditional employer. And there's like some sort of like, discontentment or misalignment with that employer and that kind of has them jumping into private practice, right?

James Childress:
Yeah, yeah.

Melvin Varghese:
Right. Is that broadly like pattern that you've seen as well?

James Childress:
It's true. And so I guess there's a couple of things I typically see operating, you know, one they're working for an employer and they just feel like, you know, this vibe is not working for me. They don't align with the mission, you know, so to speak, like some of them, and it can be like in a positive light or a negative light. They, maybe they're like, I don't think the practices here are the types of things I want to support. Or it could just be, Hey, I want to focus in a certain niche. or I really want to pursue the independence of having my own practice or sort of the adventure of being an entrepreneur. And especially if you haven't done it before, it can sometimes look maybe a little bit more appealing than those who've been through the experience. But certainly at the start, there's like, hey, I really this is something I want to tackle. I want to do this on my own. I want to have my own thing. And that is kind of the American dream, so to speak, is to sort of carve something out for yourself and make it happen. And so, yeah, I think there's a lot of things that can be attractive, you know, from every side of it, you know, whether it's a positive thing that sends them, you know, zooming off in a different direction or something that they are actually displeased with. I think both can exist. So, yeah.

Melvin Varghese:
Thank you for saying all of that. And I think even broadly, I've noticed another pattern, which is, I feel like some therapists, when they decide to go into private practice, they're like burn the ships down. I'm going all in, like quitting my job, like going in next week, doing all the, you know, set up LLC, like bank accounts, like set up my, you know, online directory profile, whatever. Right. And then there's like other therapists that will, be like a lot more like, okay, I think I want to do this maybe in the next year. Let me build out like an income, like a backlog of income, say, set aside some savings broadly, again, like what are you sort of seeing like pattern wise among therapists?

James Childress:
Yeah. In terms of what they're doing and how they approach that.

Melvin Varghese:
Yeah. Like how they jump in.

James Childress:
Yeah. I see like a lot of the solos that we've worked with who are starting, they're often supported by, you know, a spouse income, you know, so they're not sort of the lone ranger as you might sort of imagine it all the time. But the ones who aren't or the ones who are a little bit more prudent and kind of conscientious or careful, they're going to sort of bank things up a little bit. They want to sort of see that flywheel start to move a little bit before they sort of commit. And I think that's appropriate. You know, it's like they say in project management, everything takes longer than you expect. And it really, really does. It takes more time. It takes more money. It takes more attention. You just don't know until you're in it, you know, sometimes. And so I really recommend getting a good strong foundation and really sort of reassessing that foundation before you sort of make any big changes, because that's that's really important. You don't know until you're in it what some of the pitfalls are. And there's a list on that front.

Melvin Varghese:
Yeah, we'll definitely talk about some of those pitfalls. This is a really silly question, but broadly, do you have a recommendation of how much income to have in a backlog as somebody starts a private practice? For example, if you're working in an agency like a three month cushion or something like that. Because I would imagine for most people, you're not going to have a full caseload within like one or two months, you know.

James Childress:
You won't. Yeah. And that is one of the things that I think is most important to figure out is actually that caseload growth and sort of what it takes to get that caseload growing, because that is what gives you that number, right? So if you get a sense that you can create a certain amount of increase over a certain period of time with a certain amount of either hustle or cash, you sort of get that sense, okay, this is predictable. I can do sort of a conservative view of this. But if I were to kind of answer that in terms of like a number, it would depend on the time of year, right? Because we are in a somewhat seasonal profession, a seasonal service industry. It varies depending on the state. It varies depending on the demographic they're serving, the diagnoses they tend to work with more and the modalities. But there tends to be kind of a drop in December. Well, it's not retail. Retail goes up in December. We tend to go down as everyone's out shopping or, you know, visiting the family or whatever. And then the summer is often kind of a reliable slow point. So I would say stage things based on, you know, learning from your peers in your local area. What are the areas where things are growing? And then make sure you have on hand the amount of cash that can support things through any sort of slump. that you might experience and then have at least enough on hand for like that slow time. So let's say it's summer. That is typically the slowest time before you kick things off. I would try to kick that private practice off during a time when things are going to grow, which typically is January through May is when we see a big rally. Sometimes, you know, there's a good section in the fall where it rallies as well. But then also have the cash on hand to support a slow season in case you don't really see. So, you know, in case you're just kind of maintaining through that first kind of busy period and sort of getting your bearings. So if we had to throw out a number, it might be like three months of, you know, personal expenses. But, you know, the better your foundation, you have the less risk you have. And so it's mostly kind of gauging that and some of the some of the challenge we find in being an entrepreneur is taking our enthusiastic foot from the gas to the brake, slowing things down a little bit. That can be kind of the hard part is taking your time when you really, really don't want to.

Melvin Varghese:
Yeah, absolutely. And then also, thank you for normalizing the time, when to start. I think I broadly understood that, but I've never heard someone put it into those words. So thank you for that. The underlying thing is, it's not just about starting a private practice, right? There's some business strategy that you've got to really think about. And also, like, I don't know, for whatever reason, let's say, for example, you are locked into starting your private practice in the summer, like not being so hard on yourself, realizing like broadly, private practices do have a summer slump.

James Childress:
Yeah. And when we're savvy business owners and entrepreneurs, let me back this up by someone authoritative. So I'm a big fan of William Edwards Deming. I use his principles in a lot of the things I do, and he's largely credited with being responsible or at least a main instigator for the Japanese economic miracle, which is basically where Japan in 20 or 30 years went from total destruction after World War II to being the third largest economic superpower. So anyway, I talk about Deming all the time. My team members really get tired of it. One of the things he advocated was data-based decisions. And he famously said, without data, you're just another person with an opinion. And that cuts through the noise for a lot of entrepreneurs and business owners. Going with your gut is when it comes to business, it can often be somewhat overrated. There's some value to that in certain instances, but you want to pair that with as much data as possible. And often when we think about data, we sort of lump it in this category of like huge spreadsheets of statistics and stuff. But it's just sort of what you see and what you know. And so when you think about launching a private practice or a business of any type, you really want this thing to succeed. And think about that in the big picture. Don't think about necessarily, you want to think about the potential, but don't bank on the potential. Fight for the potential and go with what you can expect. which is what you can expect is there will be some surprises, some things you don't expect. And there will be some challenges that you didn't expect. And you want to have as strong a foundation as possible. You want to eliminate as much risk in that endeavor as possible. So you can have the highest likelihood of success, not just, you know, success in a timeframe, but success, period. And so that's where those things come in. Like what's going on in your local area? Is it under-saturated? Is there a specific, you know, segment that you feel like you could serve better where you might have a better likelihood of success? Like just what are all the things you can kind of extrapolate and pull from what you know and what you see? Use it, you know, don't ignore it, but use it. And that will create a stronger foundation. That foundation can be cash. It can be resources. It can be skills, but it also can be, you know, that data. Like, what do I see in the market? What is going on around me? And how can I pursue this endeavor with the highest likelihood of success? Not necessarily speed, but highest likelihood of success.

Melvin Varghese:
How do you find like local data like that? Like, is it just broadly like looking on like an online directory? I guess what are trends that are happening in your local area? Is it just how would a therapist go about finding that information or water somewhere?

James Childress:
Yeah, you can join, you know, local associations like counseling associations, psychology associations are typically governed by state. You can develop your own peer group by finding people on LinkedIn that you sort of mesh with asking questions and sort of. just navigating that space, finding a mentor. Maybe there's a real sort of competitive pairing. Like let's say their focus is really like anxiety and depression and your focus is ADHD or you know, this is just they're in an area that you're not in. Buddy up, create sort of a peer group of the two of you, share your notes and see if you can support each other. Right. So all those things can be, you know, research. I'm using air quotes for the people who are listening, but that can be research. Right. And data. You know, it sounds like we're just having a chat and we're having a conversation, which, of course, we are. But you're learning great things about your market. You're building a network, you're gaining resources. And, you know, it's amazing the way just having someone you can sort of tap into a small group that you're connected with, the level of support you can get from that, because you can avoid a complete disaster by someone just sharing something, one minute conversation saying, oh, no, no, go left instead of right. It can be immensely valuable. And that's another thing. And again, you know, I'm trying to, for someone who's starting a private practice like that, that's something you can do that doesn't cost a lot of money, right? It just sort of takes some time and sort of takes some, you know, some networking and sort of building some relationships, creating some trust with some people that are in your area. It doesn't cost you much money, maybe a cup of coffee, like we were talking about at that conference, you know, but it can really be invaluable when you find yourself sort of in a pickle facing a surprise or a challenge you didn't expect.

Melvin Varghese:
Yeah, I mean, it's that thing of like private practice is both about the ambition side of it, but it's also like the humility side of it. And this, like you said, the image was fantastic, like knowing when to push the gas and knowing when to press the brake when most of you in their initial stages, most of us like want to just pedal to the metal, like, you know, and go, go, go. And there can be so much wisdom in learning like, oh, that would have been a really not good path, like it may have been okay for now, but I didn't think about that, the repercussions of that like three, five years from now.

James Childress:
Yeah, it's amazing someone who's been and done the things they can share that we don't necessarily see at the start.

Melvin Varghese:
Yeah, absolutely. You know, as therapists, we manage so many roles in private practice, from being a clinician to a business owner, to doing all the things that we need to do to market our practice. It's really easy for all of us to feel overwhelmed, especially when we are juggling so many things. That's where the team at Alma comes in. This is a platform that I would consider if you are a solo practitioner that is either wants to take insurance or that is private pay but just wants to hedge a little bit especially to account for periods of economic uncertainty or weird things like hyperinflation like we've been dealing with in more recent times. Alma makes it easier than ever to build a thriving private practice. They include a bunch of different cool stuff. So one is they have a members-only platform where you can exchange resources with other clinicians, exchange referrals, and just find support. They have consultation groups as well. And they also offer CEUs as part of your membership at no additional cost. These are both live and on demand. Now, in order to get credentialed with Alma, typically to get credentialed with insurance, it takes months and months, but Alma actually has a 45-day credentialing process and you actually get increased reimbursement rates. So they're often higher than if you were to go just through the insurance carrier and if you were just apply as a solo practitioner. And the really cool thing is they guarantee payback within two weeks of when you see the client so that you can ensure your income stays steady. You can see as few as like one client or two clients just to hedge a little bit. And Hama also has a HIPAA compliant telehealth platform so that everything is safe and secure. Alma also has a bunch of different stuff to support clinicians, all the way from workshops and all sorts of things, as well as an online directory, so that you can continue to get referrals coming your way. The best part, the team at Alma was able to hook the Selling the Couch family and listeners with a unique code, which is over at sellingthecouch.com forward slash Alma. That's actually for two months absolutely free on Alma's platform. This is a non-advertised, like non-publicly advertised discount. So definitely encourage you to check it out over at sellingthecouch.com forward slash Alma for a 60 day free trial just to see if it makes sense for you. James, I wanted to shift over to kind of the crux of our conversation. Again, we titled this Uncomfortable Truths About Private Practice Finances. And let's even start like one at a time. What would be like, and broadly, it's like the top kind of three emerging trends that you're seeing when it comes to private practice finances. So this isn't even when somebody just starting, but even somebody that's like an established solo practitioner or practitioner as well. Let's just start wherever you want to start and we can dive deep in.

James Childress: though.
The biggest trends in private practice finance.

Melvin Varghese:
Yeah. Biggest trends are like uncomfortable truths, whatever, however you want to.

James Childress:
Sure. Yeah. I also like to kind of share, you know, before I share uncomfortable truths or potentially get into the side of things that's somewhat critical, I think it's important to share, you know, I come to this from my own personal experience in therapy and I found it transformative and I admire therapists immensely because I was able to find answers I wasn't able to find anywhere else. And so I'm definitely an advocate for therapists. And so I'd like to start that as a preference before I say anything that could verge on the area of being critical is because I want private practice to succeed. But that being said, one of the biggest things I see is especially when group practices start, there's a size, there's a size of group practice that is inherently unstable. And what I mean by that is that most clinicians are going to go to a group practice because they don't want to do all the things. And so there's going to be a demand for the admin side, the billing side, marketing side, et cetera, et cetera, et cetera, to be handled by the practice itself. And there's a stage and this is kind of the stressor, like a lot of people talk about quotas and having to hit session counts and all these other types of things. Sort of the nucleus of that is that sort of operator, it's sort of that mechanism. And I'm always a big fan of like, let's get to the thing that's sort of black and white inside of it all that makes it clear. What's going on there is the clinicians want all those things to be off their plate so they can just practice and they can just serve their patients. Well, in turn, if the practice is not sizable enough to support all of those things, then basically what happens is everyone inside that practice is like bootstrapping, right? The resources are kind of slim and the ability to provide that thing that the clinicians are wanting and needing is less and less. And then also the owner is now doing a group practice. They're trying to get this thing off the ground. Sort of everyone is feeling kind of this scarcity and sort of stringent operation of things. It's important to know that that's a phase that we need to pass through. And that's the uncomfortable truth. The uncomfortable truth is there's sort of a set point where the juice is kind of worth the squeeze, so to speak, you know, where there's enough going on. And like, I saw this pretty clear that I was presenting at APA. in Seattle and I was talking about, you know, net income percentages and the average in the industry is 14%. And I mentioned that to someone and they said, Oh man, that's not enough. I don't know why I would do this for 14%. And I was like, well, what does that 14% applied to? Is it applied to 100,000? Is it applied to 2 million? And the question is, like, if all we have left is a small number, it's not going to be incentivizing. And so what we have to advocate then is we have to advocate getting past the stage where there's just not enough to go around and just not enough to make it worthwhile. And that's that sort of bootstrapping phase where every other business out there is going to try to get past it. Or they're in that spot where they're in this role where they're wearing every single hat and they're, you know, doing all of the different things. And now that practice owner feels like they're not owning a practice. The practice is owning them. And and it gets very, very laborious and tedious. And the real problem that happens then is they start to resent that practice. They start to feel like, oh, man, why did I do this? And that's a real shame. You know, so like that, I'm a real advocate for that. They have to get past those stages. where it's really scarce, really stringent, really, really tight. They have to fight to get past those stages and make as many really, really good decisions along that track. And if possible, make it as short a journey as possible by really acknowledging what they're after. And so that's that first one is sort of the bootstrapping practice thing. It's, it's, it's a little bit hard to think about there being this stage where everyone's sort of in the same boat and it's no one's exactly at that point getting what they're really wanting out of this.

Melvin Varghese:
What's a common thing that like a group practice at that stage is doing that kind of keeps them stuck at that stage?

James Childress:
Yeah. So what I'll often see is the practice owner will hire admin staff and they're often overstaffed on the admin side because they're trying to meet a demand that they see in the rest of the practice. Right. And so that creates sort of this imbalance. And this is where we talk about balancing and benchmarking all this type of stuff. People think it's just a bunch of. you know, numbers and things, but really there's a balance. There's a balance between the amount we can invest in sort of the admin team, however size that is, and we want to keep them highly accountable and productive to all the results they're working on. And so that we preserve that capital, not just for the clinicians, but also for the marketing to continue our growth track. Also, all the other things that go into making sure that the inside of the practice is growing as much as the outside of the practice. The outside is going to be that base of customers and everything, the patients that are coming to that practice for all the help. The inside is going to be that structure and foundation like we talked about that makes sure that all those resources are coming to bear and everyone inside the practice is getting what they need. So that's the big thing I see. I was talking with one practitioner, and this is an example. She had five providers in her practice, and she had five admin people. And what she was hearing from the admin people was she was hearing that they were just overwhelmed with work. Well, he shouldn't have five providers and five admin. That's a little out of balance. And she was feeling it. She was feeling in the pocketbook and things weren't going well. And so that's the typical thing. Like, you know, be very, very clear on the admin side of that practice. That's got to be one of the most efficiently run things you've ever seen. It's got to be tight. It's got to be very, very efficient. And there's got to be some really, really strong accountability between the practice owner and all of those admin supporters. They really, really need to produce and be effective so that the space that the clinicians are operating in can be the right space and they can do all their work.

Melvin Varghese:
Is there a broadly like a number, like for example, one admin per three clinicians, like anything like that, that's sort of like a, or does it really depend on like, I guess, the type of practice, what they're doing, therapy versus assessments, like, like anything like that?

James Childress:
Yeah, it does kind of depend on what they're doing. And so I wouldn't necessarily, I can't necessarily use kind of a benchmark in terms of headcount. But what I will say is that for the clinical side of things, what we often see happening with a lot of group practices, this is maybe a little bit of an uncomfortable truth as well. is there on the admin side and the supervision side, things increase based on headcount. The demands increase based on headcount, but the revenue increases based on sessions. Right. And so if we see a lot of folks coming into a group practice where on average, we've got sort of a part time clinician base, What we're going to see is we're going to see the admin and the supervisor load be really significant because they're serving all the people. But then the revenue is dictated by the sessions. And so another way I like to describe it is sometimes we'll have a situation. This is, again, a bugaboo about, you know, billable sessions, you know. But sometimes we'll see a situation where the session load is spread out over a significant number of people. And what we've done is we've traded a concern over clinician burnout for an alternative concern of supervisor burnout. Because now the supervisors are basically, their attention is spread across a head count, not necessarily a session count. And so that's sort of that balance. And so when you think about that, if we get that in check, we're not only protecting, hopefully protecting clinicians against, you know, safety concerns and workplace concerns, but we're also protecting supervisors. We can keep things kind of nice and neat and efficient and then have the right accountability in place for the admin team and judge that based on like their success and their progress along their tasks and the efficiency and thing. The other thing I will say is, is, uh, and this is a big, very important thing is whenever we're working with the admin team, we have to. Pass through a few gates for whether or not we're going to hire. And we need to make sure one, that the admin team is doing things in the right timing. You know, there might be things they're doing monthly that they really should only be doing quarterly or annually, you know, like we don't actually just need that that much, you know, that's good to make a point in. And it also may be that, you know, instead of hiring another person to do a task in a manual way, perhaps there's a software or perhaps there's an outside service. You know, I'm a really big advocate and we've seen this play out in the business world. Businesses that bring on external resources like experts and like, you know, little areas in the business, they tend to get ahead a little bit faster as opposed to everyone's sort of reinventing the wheel as they go. Billing especially is a big one for that. I'll see practices hire sort of a biller and an internal biller, one person, and that person will learn how to do all the things. I definitely appreciate people learning and everything, but when you're a small group practice, it can be very good to hire an expert because if that billing gets behind, and I've seen it, we had a client we brought on a few months ago, they had four years of billing that wasn't collected. Four years. And it was just because it was like, hey, they hired someone and that person did their best. And I don't necessarily think anyone was nefarious, but it was like, wearing a pickle, you know, and hopefully we would have in the all best scenarios, we would have seen this sooner.

Melvin Varghese:
Thanks for noting that one. What's another kind of uncomfortable truth or emerging trend that you've seen?

James Childress:
Yeah. You know, I think one of the big things I like to advocate and it's a little bit bittersweet, but I think therapists really, really need to succeed. And I mean that like in every area, like the real truth is they've got to want it all. And they've got to want it all. They've got to, they've got to want to serve their patients really, really well. They've got to want to make good money. They've got to want to have a very efficient business. They've got to want to have an excellent brand that pulls people in. They've got to want demonstrable results with their patients. They actually need to have it all. And I say that because, you know, we're heading into this space where the stigma is subsiding or, well, subsiding, it's still subsiding, and diagnoses are increasing and people are facing challenges. But in turn, people are also realizing Hey, I can just get help with this. Like, I don't have to be a wreck. Again, I'm using air quotes. I don't have to be a wreck to talk to a therapist and get this incredible experience of the objective experience of someone who can help me understand myself. It's amazing. And I think more people are starting to see that. So what we need is we need more therapists coming into the space. And that means we have to increase these average clinician incomes. We have to improve those outcomes. They have to be doing better, because we have to make it attractive. This is the big mistake that my profession made. 75% of the CPAs that were working in 2010 have retired by now. They're gone. 75%. And for every three that were retiring, one was sitting for the exam and most of them didn't pass and then most of them when they got in the industry, they didn't stay. And so, you know, there's not a lot of CPAs, you know, it's harder to find and everyone complains about how their CPA doesn't pay any attention to them and everything like that. And that's a real issue for our profession. I'm on one of our state societies and the discussion all the time is what they call pipeline, which is like how to get people into the profession. And I'm the one who always says, hey, wouldn't it help if they got paid more? You know, and it's like, but it's not just one problem. Like you can't just sort of chop a tree down and fix everybody's pay. It's systemic. And it's like it's lots and lots of little levers that we have to pull to make all these things run right. We've got to make sure like in private practice, we've got to make sure cash flow is good and billing's good. And we're adjusting our average revenue rate. and things are growing at a decent clip and we know what our future is going to be, we know what our past was, like we can make really confident decisions moving our foot from the gas to the brake or the brake to get to the gas. So that uncomfortable truth is they really have to want it all otherwise I think in five to ten years we're all going to be really frustrated because the status of these group practices isn't going to be really what we want. And we're not going to be seeing a lot of people flocking to this as a profession where they can serve others and indeed also serve themselves.

Melvin Varghese:
Man, so fascinating how you phrased that. Because in the moment, you're just thinking about sustaining a practice, whether it's solo or group. But we're not thinking about the ripple effects, the downstream effects of the actions that we do now. and how can it impact like perception of the field, future earning potential, all of that. That's like really fascinating. What's like a normal rate of growth, like healthy growth for like a solo group practice? Again, I could imagine this probably depends on the area, type of clients, like, I don't know. So I guess that's like one part. I have a second part, but I'll let you answer that first part, so. Sure.

James Childress:
Yeah. So I would first say that, you know, balanced growth is essential, right? External growth and internal growth. But it's not uncommon for a practice to double within two years if the right things are in place. I mean, what we've seen with everything after COVID and with the climate around mental health changing, growth can happen relatively quickly. producing good outcomes, having patients be satisfied and having all the right connections be out there and building a referral network, you can have the incoming requests and everything. And that's really what we're after is to take advantage of this but take advantages in the right way because the thing I'm a big advocate of as well is I think clinicians should supervise clinicians and because I've been in the therapy session and I understand compassion fatigue as a patient and sympathetic trauma as a patient, I've gotten to the end of a session being like, are you actually going to go talk to someone else now? Like you've got to be kidding me, you guys have your ways of managing that and everything. But I don't think that people who aren't clinicians understand that space and that experience. It's almost like when you think about it from my perspective, again as a patient, but it's more intimate than even like the most complex surgery because you're actually the emotions that are involved are actually experienced by both parties. And that's challenging. I see it as challenging. And so I think it's very important that clinicians be supervised, led and managed by clinicians. And that is why this is important. And I was thinking about all the interesting things I thought would be worth sharing. So I apologize if I'm rambling. That's part of it, I think, is that clinicians leading clinicians is really what we're after. And the biggest kind of ripple effect we're trying to create is we want people who are entirely outside of this profession to sort of have their ears perk up and say, oh, wait, I could do that. Oh, and I could make some decent money and I could have a great career. I could have all those things. I could be really proud of myself at the end of the day for the work I've done. And I could have a retirement, you know, like all the things. I mean, so we have to pave that way. We have to make that happen.

Melvin Varghese: Thank you for saying that and like normalizing all of that. I think we have we have our final one. What would you say is kind of a third uncomfortable truth or emerging trend when it comes to private practice finances?

James Childress: Yeah, so, and it's a little bit different than I think what most people would expect me to say, but the way I like to say it is the external environment must match the internal environment. And again, I try to sort of get to like basic truths. I try to not be the, you know, the messenger as much as someone who's pointing to the message. But we see this like one of the best ways I think it's described as, you know, Sam Walton, the guy who created Walmart, you know, back when it was less of a sort of corporate juggernaut, like it is now, it was, you know, at the original start, a lot of these businesses that are doing well, they're doing well because they really, really serve customers. But he said, there is only one boss, the customer. And they can fire everyone from the chairman on down just by spending their money someplace else. Now, as a business owner and an entrepreneur, what you realize, and this is where things get sort of tough sometimes, is you realize the external environment is full of customers that may ignore you completely, may not understand your message, may hear the message that's perfect for them and still not buy. And they may show up and they may stick around a while and you'll think it's going to last and they leave. Like there's this real challenge. And this is why marketing is so important because the experience in the external environment of any business and a practice can be this sort of ambivalent and like transient sort of customer experience where it's like, why isn't this working? Why aren't we getting traction? Don't they know we can help them? like all these things and businesses that do really well ensure that the inside of the company, the internal environment matches that external environment. This is, they can sum it up by saying things like product market fit, right? Does our product match our customer? And sometimes it has to match in ways even the customer doesn't know that they're needing this thing, right? But the internal environment has to match the external environment that has to take place. That fit has to take place. And so the uncomfortable truth is then everything inside that internal environment has to adapt to the external environment. And so sometimes like this is what happens, you know, I'm working with practice owners and they're talking about conversations, you know, it'll be between sort of them and like a clinician or a supervisor and admin person, like they're kind of experiencing a little bit of friction. The thing that sort of cuts through that noise is What about the patient? How does this serve the patient? But how does this serve the patient as a customer? Right? The uncomfortable truth then about finance is productivity is essential. Product market fit is essential. Actually, truly catering to the needs of the customer in the right way. both ethically as a provider and a practitioner, but also like business to customer. Like how are we meeting their needs? How are we not only meeting their needs, but how are we helping them make sure they know their needs are met? Because maybe they don't know. Maybe they don't know what we had just accomplished in that session. That's why things like collaborative charting are so interesting to me and hopefully everybody. But that's that nugget. And if it's not working right, if that product market fit isn't working right, we're going to lose ground. We really are going to lose ground. And it will be obvious in the financials. We'll see a lot of patient turnover. We'll see a lot of clinician turnover because we also have an internal thing, product market fit, the market of talent. What is talent needing when they come here? Not only do they want all the admin things to be taken off their plate, what else are they looking for? What else are they trying to accomplish and what can we effectively deliver to them? So that's kind of that thing. That's just a way to think about it. And, you know, it keeps us away from looking at a big spreadsheet full of numbers and talking about all that boring stuff. But, uh, it's a very, very important challenge, you know, making sure that we are matching and it can be insidious sometimes just the little details that have the biggest impact. So.

Melvin Varghese:
Yeah, I'm just like, the one thing I'm taking away from our conversation is one is like how many layers one has to consider. And hearing this is not like, meant to intimidate you. It's meant to like inform you and to be thoughtful about it. Because I was even thinking about like my own clinical journey. I was at a previous group practice. I remember there was situations where it was evident that we needed certain things, and certain things that seemed like basic things, but then they weren't really willing to do that. And then there was this huge turnover of clinicians. And it's such a, I don't know, I think I'd like us think about it, like, maybe think about like, probably what was happening, like, there was like this internal, the external environment wasn't matching, like the internal

James Childress:
Yeah, that's great. And I see that too. Like, and, you know, just as I guess one example, that's kind of interesting is another sort of corporate juggernaut, but Amazon at its start had a lot of very good things going for it. And one of the things I think they did that was really exceptional is on all their executive meetings and the board meetings, they'd have an empty chair at the table. And that was meant to represent the customer. And it was like, let us never forget who this is supposed to serve, because if we lose sight of that, it all goes sideways. But yeah, I just thought I'd share that because that probably was a little bit missing there, you know, where and you probably had some of those clinicians in that experience where they were like, you know, thinking like, hey, these people need something different, needs to operate different. I just know it needs to operate different. In a right setting, everyone should be able to raise their hand and say, Hey, this isn't working. My customer who I'm having a direct experience with because the folks further up don't, right? So they need that input, like on the ground level, that customer interaction. How did that go? Did they get what they needed? Were they satisfied? You know, those things have to be shared. And if they're not, if that gap is closed, then there's no hope for that. Those two environments to match. They'll never match.

Melvin Varghese:
Yeah, James, I'm so grateful for you, grateful for our friendship, grateful for you coming on the podcast. Where can we learn more about you and the awesome work that you're doing with therapists?

James Childress:
Oh, yeah. Thanks so much, Melvin, for having me. Our website is cacadvisors.com and we'd love to hear from anyone who might want to chat. No pressure. We're not boring snobs as some of our peers might be. We'd love to hear what your challenges are, see if there's any way we can support you.

Melvin Varghese:
Awesome. Thank you so much, James. Have a great rest of your day and we'll talk soon. Hey there, I hope you enjoyed my conversation with James and especially if you are starting private practice or you are in private practice or you're a seasoned practitioner, whether it's a solo practice or a group practice, I hope today's session has just been really helpful for you. I was trying to think about like, you know, what are my sort of big takeaways I wanted to focus on the first thing that James talked about, which is realizing that there is a seasonal nature to private practice. And I would even say like most businesses probably have a seasonal nature. And so when you're first starting out, thinking through where can you start if it's possible, right? Like when can you start the private practice in a way that helps you ride the momentum wave, right? And even if you are like established, I think one thing to really think about is if you're building on new products and services, when can you time those? In relation to when there might be demand so for example with like our online course mastermind there's like a legitimate reason why we launched it in. We have two launches we have one in the spring. or early in the year, like mid-January, and then we have one that's like end of summer into the fall. And the main reason was because we noticed that's usually the space when clinicians are most excited and ready to create something and create a course. It didn't really make sense to do it in the summer when there's like, you know, maybe travel and stuff like that. Again, that's just a personal example from STC, but it's something that I thought a lot about as James was sharing. It's not just about launching the thing, it's about the timing of launching the thing. That's also equally important. James' website is over again at cacadvisors.com. And definitely if you have tax kind of questions and just want to get a second perspective on things please don't hesitate to reach out to him. I've gotten to know James online and then obviously we shared a meal and yeah it's just a great vibe that I got from James and I know like you know he's just one of the good folks doing good work to serve our field. Have a great rest of our day and I will talk to you soon. Bye.

Narrator:
Thanks for listening to the Selling the Couch podcast. For more great content and to stay up to date, visit www.sellingthecouch.com.

Melvin Varghese:
Hey there, thank you so much for tuning in to today's session. Just wanted to also let you know that we have a free email newsletter that goes out every week. You can download it over at sellingthecouch.com forward slash newsletter. Basically that newsletter contains some of the stuff that's happening behind the scenes with STC and also with my life and how I'm balancing and trying to balance being both an entrepreneur as well as building a life around my family and my health as well. And it also contains the latest podcast episode and some of the stuff that I'm doing on LinkedIn, some of the strategies and things that are working for me. And then finally, a brand new section called On Mel's Mind, where I take a video or a book or a blog post or something like that that's inspiring me for that week, and I share how I'm implementing it both in my life and in my business. Again, you can download that over at signthecouch.com forward slash newsletter. And if you are one of the 3,700 colleagues that have been a part of the email newsletter, I so appreciate you and I'm grateful for your support. We genuinely try to make these helpful and just based on the data and based on the feedback we're getting, it seems like we're doing a really good job. So appreciate you and I hope that you have a great day.

timestamps00:00:00 – Preparing for Private Practice Success
00:05:30 – Meeting James Childers: Insights from a CPA
00:10:02 – The Journey from Employment to Private Practice
00:15:15 – Building a Strong Foundation Before Launching
00:19:03 – Understanding Seasonal Trends in Private Practice
00:24:49 – The Bootstrapping Phase of Group Practices
00:30:03 – Balancing Admin and Clinical Staff in Group Practices
00:33:50 – The Importance of Competitive Compensation
00:40:32 – Aligning Internal and External Environments
00:44:37 – Key Takeaways and Final Thoughts

selling the couch podcast with melvin varghese phdWeekly interviews, strategy, and advice for building your private practice in and beyond the therapy room.

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It contains a lot of practical tips that we've learned as STC has reached 1.81 million+ downloads and become a 6-figure business with podcasting as the backbone.

James Childress is a CPA whose practice primarily focuses on working with therapists, giving him a unique perspective on today’s topic. In this episode, we cover the top three uncomfortable aspects of private practice that can lead to imbalance and big problems. James shares insights that help us better understand business ownership, financial stability, and the seasonal nature of private practice.