Fighting the Therapist Farms: Why Small Group Practices Matter with Jessica Frick, LPC

In this episode, host Sivie Suckerman, LMHC welcomes her guest, Jessica Frick, LPC.  Drawing on her background in community mental health, Jessica shares vital updates on her macro-level advocacy work within the Mental Health Insurance Reform Task Force and the Pennsylvania Counseling Association. Their conversation focuses on the current challenges mental health professionals face regarding insurance companies and venture capital-backed platforms. Jessica and Sivie discuss these "therapist farms" that exploit clinicians and complicate the therapeutic relationship by causing unpredictable billing issues for clients. They also raise alarms about the "uberization of therapy" and vertical integration, noting that insurance companies are increasingly buying out mental health agencies and pressuring providers to contract through VC platforms. 

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Jessica Frick, LPC

Jessica Frick is a licensed professional counselor (LPC) in Pennsylvania and group practice owner. Jessica is a member of the Pennsylvania Counseling Association's Goverment Outreach Committee and works with the Legislative Subcommittee to advocate for reform within PA. Jessica is also one of PA's state leads within the Mental Health Insurance Reform Task Force (MHIRTF). As an experienced therapist with over five years of practice, I specialize in working with adults who have emotionally immature parents or have experienced emotional abuse during childhood. I am committed to helping clients heal and thrive through validation, support, and education about their backgrounds and history. Utilizing Acceptance and Commitment Therapy (ACT), I empower individuals to navigate through challenging emotions, break free from self-limiting beliefs, and prioritize their own well-being. Through compassionate guidance, validation, and skills exercises, I assist clients in reconnecting with their emotions and rediscovering their innate strength. If you're seeking a safe space to heal from past wounds and create a more fulfilling life, I invite you to embark on this transformative journey with me.

Metamorphosis Counseling

This episode was produced and edited by Sivie Suckerman, MA, LMHC, ACS

Transcript

SPEAKER_01 0:09

Hey everybody, my name is Civy Suckerman, and this is Therapists Unchained, a podcast hoping to educate, empower, and inspire mental health clinicians across the country, navigating the systems that we're facing and learning more about the current mental health landscape that we're in. Today I have Jessica Frick, who is a licensed professional counselor in Pennsylvania. She's also a small group practice owner like myself. Her group practice is called Metamorphosis Counseling. She has six clinicians, including herself. So it's a small group practice. And Jessica specializes in with high-conflict loved ones, which I'm very fascinated with, but this is not a clinical podcast. But that's that's a that's a point of interest for me as well. We did a quick pre-interview before uh recording today. And one of the things that Jessica said that made me laugh was that she really hates insurance. So I'm sure that we're gonna be hearing more about that today. I met Jessica through the Mental Health Insurance Reform Task Force, which I've discussed on this podcast before. I've had Nicole Sartini, who was the founder of the Mental Health Insurance Reform Task Force, on the podcast now twice. Jessica is the co-lead for the state of Pennsylvania with the task force. And Jessica and I were joking before we started recording that we need to find an acronym word to so it's not me, to be able to talk about the mental health insurance reform task for us because it's so many words. Anyway, oh, she's also the legislative outreach committee. Was it chair?

SPEAKER_00 1:43

No, I wish. No, but I Oh, you're you're on the legislative okay.

SPEAKER_01 1:47

You're a member of the legislative outreach committee for the Pennsylvania Counseling Association, which is their state chapter of the ACA. Welcome, Jessica. That's a lot. I just kind of like I unload it. Did it make you feel like, wow, I do a lot of stuff? I have done a lot of stuff, yeah. Yeah. Yeah.

SPEAKER_02 2:09

I know. It's like, oh, look how special I am.

SPEAKER_01 2:12

No, I love it though. Jessica and I met briefly at the last state lead meeting for the task force. I'm just gonna say task force because it's too many ways. Thank you. And she was quick to reach out to me around being able to talk with me on the podcast, which I super appreciate. So welcome, Jessica. We're glad that you're here. Thank you. And glad to be here. A couple things that really stuck out to me. Number one, being a small group practice owner like myself, my practice is a little bit bigger. We're at about 10 clinicians, but still small compared to like the systems, like these venture capital like headway. Right. So, what I like to start with is just to give folks a sense of your trajectory in the field and how you started to move towards doing all this advocacy work that you're doing.

SPEAKER_00 2:58

Awesome. Yeah, thank you so much for for that great intro. I was listening to your episode with Nicole, and and I actually had a similar trajectory to start, that I decided to be a therapist while talking with my own therapist, which was really funny. I want to say I was the same age actually. Um, I was in my early 20s, and I was going to be an engineer, believe it or not.

SPEAKER_04 3:19

Wow.

SPEAKER_00 3:19

Did not pan out. Uh, I did not realize how much math was involved in engineering, and the math gene skipped me. So I was looking for something else to do because I was feeling very purposeless in my life, and at that moment, kind of realized mental health could be an interesting thing to do. Did my bachelor's and was going to work with kids in therapeutic support, like in schools. Hated that. So decided to go back and become a therapist. I knew from the top that I wanted to be uh in private practice, and so I did that alone for a little while, and then you know, just making more friends in the community realized that I really do want to make a space that allows for clinicians to have community while also allowing them to have autonomy and the respect that I think root practice gives. I'm from Erie and we have a lot of really fantastic community mental health agencies around here. It's a great thing to have as we we have a lot of resources for people with mental health, but the community mental health like world is tough for therapists. Oh, right? Absolutely. You you you're overworked, you're underpaid, you're often working with clients that you have no idea how to work with, you know. And when I wouldn't trade my experience in community mental health with an for anything, I was hoping that maybe it would we we would make a space that people can feel respected and cared for.

SPEAKER_01 4:40

So here I so I mean it this resonates so deeply. How long did you work in community mental health?

SPEAKER_00 4:46

Oh god, five-ish years. Wow, no, like seven years, I think in various roles. Yeah.

SPEAKER_01 4:52

So how long have you been in the field total at this point? Uh 12 years, I think.

SPEAKER_00 4:58

Okay. Yeah. Yeah.

SPEAKER_01 5:00

Yeah. So I feel so aligned with that, and I've talked about it in other episodes, and it's something I'm passionate about as far as the exploitation in the field. And a lot of it is by design, but I think it also kind of breeds ongoing exploitation. And I, you know, I've had my own experiences, even within the group practice space, that have been exploitive. And I think that I love hearing about small group practice owners like you who are being really intentional and thoughtful about their mission, vision, values of why they're doing it and leading with like a real sense of community, like you said, community support, that there's an intentionality around it because I get concerned about the exploitation in the field, which potentially is pushing people towards these venture-backed platforms because it's like, you know, maybe I'll make a little bit more money. I'm not being sold something that isn't true, or I'm not being hounded and I can at least be more independent. And I would love to see sort of the I feel like group practices are kind of dying because of these venture-backed platforms. And so I would love to see more intentionality around therapist-owned practices. And I do see it here in Washington State. There are some really great practices emerging here and that have been around for a while. But I just wanted to say that because I think it's really important if there are group practice owners listening to really think about if if you would work for you.

SPEAKER_02 6:34

You know? Right, right. And that's kind of what that's kind of what where I sit.

SPEAKER_01 6:38

Like, I want to create a place that I want to work, right?

SPEAKER_00 6:42

Yeah, yeah, exactly. That's a perfect way to put it.

SPEAKER_01 6:45

Yeah. So I I appreciate that. And I know you you're a training site, you said you have an intern. And so I think that speaks to it too, as far as really trying to cultivate, which these venture back platforms can't offer, right? They can't offer that culture and community the way that a group practice can, if done with intentionality, integrity, vision. Right.

SPEAKER_00 7:06

Exactly.

SPEAKER_01 7:06

Right?

SPEAKER_00 7:07

All of those definitely not great owners, but yeah, yeah.

unknown 7:11

Yeah.

SPEAKER_00 7:11

Try to surround myself with the good ones. Exactly, exactly.

SPEAKER_01 7:15

And I like to interview the good ones because I think it's important to hear how people can operate in a way that is, again, like with integrity and with a real thoughtfulness about why they're running a group. So I would love to hear how first of all, how did you get involved? Which did you do first? I'm assuming the Pennsylvania Counseling Association.

SPEAKER_00 7:36

Yes, that was first.

SPEAKER_01 7:38

Doing the be being on the legislative outreach committee there. Right. How how did you get involved with them?

SPEAKER_00 7:45

I'm trying to remember, I know I I signed up to be a member a few years ago, whenever I just, I mean, I became aware of them and just felt like this is a good thing to be. You know, the these spaces, I mean, this was also a little bit of naivete on my part. I was still growing as like a business owner where I was thinking these organizations, you pay your dues, you you help out, and they're supposed to speak for you, they're supposed to advocate for you, they're supposed to help you be, you know, uh seen in the necessary spaces, like legislative and something like that. And once I started with the group and was really just experiencing a lot of the inequities and difficulties that I know I'm sure you will talk about and and you know kind of how that feels, I just didn't want to sit on my ass anymore. You know, I just I am the kind of person, I have no idea where it comes from, but it's it's like once I see something that's not right, like I can't just like, well, I guess that's that. Like, I have to do something about it. And so I was looking into two ways to do that and and connected with the the lead of the government relations committee, which is like the overseeing arm. And she said, I think you'd be great for our legislative outreach committee. And it was honestly similar with with the task force. I mean I was like, what is it? I just was looking for other things and just organically stumbled across Cole's kind of start of that. I can't remember on what group she was talking about it originally. And I started a little bit in 2024 when she she opened, but then I got pregnant long after that, and so I had to take some time off. So I'm very glad to be back and and really gung-ho in the work.

SPEAKER_01 9:30

I'm curious, and you know, folks have listened to a number of episodes. They've probably heard me not being a huge fan of the American Counseling Association for a number of reasons, but I also think that chapters have their own unique flavors, and so I don't want to paint a broad brush of, you know, every chapter, obviously, of the ACA. So I'm curious for our listeners, because one of the things that I really think is important is to understand at the state levels, we're all, you know, there's at this point, there's over 500 cities represented as far as people that have listened to the podcast. I'm really curious. I think we can learn from each other. And I'm curious within PCA and in the legislative outreach work that you're doing on that committee, what have been some of the things that PA has been focusing on in the legislative outreach?

SPEAKER_00 10:22

Yeah, well, I know right now, as of recording, the kind of top issue is the counseling compact, uh, something that is a passion project for you know, all of us on the committee, uh, ourselves, our leaders, uh, with the GRC, and then also with just so much connection with our own communities, everyone is looking for the counseling compact just because it's something that will really increase access. So we're we're very close to the hopefully the the bills that are necessary being passed for the counseling compact. And so that has been a major push uh within kind of all of PCA, but especially the government relation and legislative outreach committees, um, really trying to involve as many counselors in the state as possible to keep the their the legislative feet to the fire. Like this is something that matters, this is something that's going to increase access for our clients, it's going to make continuity of care easier if someone you know goes to a different state for a college or something. And so that has been probably our major focus is just let's get this enacted, especially because we're so, so close. We're like almost to the end.

SPEAKER_01 11:30

So you're one of the very few states that's not because I think we're at like isn't it? I'm gonna get it wrong, like 40 states or something. I don't know.

SPEAKER_00 11:36

Or like it's like between 35 and 40. It's a it's a lot that at least have something in the works. I think at the last stage of like Senate approval or something, uh, you know, I'm probably getting getting that wrong. But there's a lot to keep track of. It's there's so much. We talk about it all the time in the committee that just like the legalese is crazy. But it definitely, you know, it's a passion project for all of us. We all think it's really important, and so that's what we're primarily focusing on right now. But also it's an election year, and that kind of makes everything suck because nobody wants to do anything, they just kind of want to get re-elected.

SPEAKER_01 12:12

Yeah, or the focus is on something else that is exactly gonna get more people behind them than what counselors want, right? Yeah, so it's about prioritization, and often there are more flashy things to be talking about legislatively than a counseling compact, as far as just like the general public. And you may not know, I'm gonna throw this at you, and you might be like outside of my scope, and I don't know. But you know, I've been thinking because Washington State, we're a compact state. I'll be honest, I our Department of Health is kind of a mess. And, you know, they can't handle our current licensing, they're super far behind. And so then I panic and go, uh-oh, God, when the compact actually finally gets going here, even though I mean, we're approved, we're doing it. It's just the rollout part. I'm like, Jesus, if they're already like four to six months behind sometimes on getting our people licensed, what's gonna happen when the compact opens?

SPEAKER_02 13:13

I'm just it it kind of panics me.

SPEAKER_01 13:15

But also, and this is the part where you're probably like, I don't know, but I think it needs to be talked about, is it feels like a lot of decisions like this are made in vacuums without thinking about broader implications, specifically around like insurance billing. Yeah. And that we can make these compacts or these laws, but if insurance is not thought about or part of it, then there can be a misalignment as far as well, so we have this compact, but like one of our local insurance companies that the provider has to also has to be not just reside, but physically in the state that they're seeing the client in, or something like that. And I'm like, okay, so what happens then? Like, why I just feel like there's this such a disjointedness, and I appreciate the compact and the intention behind it, but it also feels like it wasn't thought through on a multi-level like like that it wasn't thought about from all the like all the different things that we face when as being a provider.

SPEAKER_00 14:24

Right. No, I I agree with you, and it's something that I've thought more about, especially since since getting involved in these areas, is just okay, hot take. People might be mad at me. I think I think that us as a population, right, as like therapists, can be very pie in the sky, like lofty dreams and goals, yeah, and not necessarily think about like the the meat and potatoes of like what's going to happen. And that's where I think we could stumble, right? Because I agree with you that we could pass this compact and sure, in like its basal form, it's gonna be good, you know, because like we have access where we didn't. But a lot of people, you know, you talk about like uh an insurance company saying, well, it's not that we're restricting access to a medication, it's just not part of our formulary. When like in in practice, it's the same thing, right? Whenever this medication is a thousand dollars.

SPEAKER_02 15:20

Because whenever I hear that, I it's like, well, we're not telling you not to take it, we're just not gonna pay for it. Well, it's like, okay, thanks. That's yeah, it's that plausible deniability. Now I'm not accountable if you die.

SPEAKER_00 15:34

Yeah. Exactly. It's like they squeeze right through that loophole. And I agree with you that more needs to be said, and that's that's where I I mean, that's one of the reasons I really wanted to join advocacy work, is because I think historically, I might be talking out of my ass. I don't know, but historically, I feel like a lot of advocacy work is done by like academics and people who, you know, like have the I guess the time to like stump and do things compared to like us trying to make billables and and do things like that. And I definitely noticed, I mean, we have a a super wide variety of of personalities and backgrounds and things like that in the PCA, which is something I really love. But definitely, like the academics have things that I never would have thought about, and I this is something I come to the table with, I feel, is like I am boots on ground with clients dealing with insurance, all these things, and so I can kind of dig into well, this is where that's gonna fall out of its face, you know. Um, and I do agree that like I don't I don't know how they did it with all the other compacts with like doctors and nurses and the SciPact and all that stuff. I don't know if they had to deal with that or not. If they did, great. Let's let's do it, talk about that.

SPEAKER_01 16:42

Honestly, honestly, that I'm so glad you said that because it's another issue that I have where I feel like, and I can only speak for counseling, which you're we're part of the same professional identity. Yeah, is that I feel like sometimes they're they work in this vacuum and they're not opening up like their relationships with these other disciplines in the field to cross-pollinate ideas, to like and maybe there I know that there is some of that happening. I'm not saying that it doesn't happen ever, but have they talked with the APA about how they I mean, maybe they did, and I'm totally off base.

SPEAKER_00 17:21

I know they could be.

SPEAKER_01 17:22

They they could be. I don't feel like I hear about that if they are, but are we sharing knowledge as far as like how were you folks able to make this work? What things do we need to be thinking about? Right. I don't feel like there's that cross-polonization of ideas in the way that I think would be really beneficial for all of the disciplines because SciPack is a great example. They they did this before we did, and I'm curious like how they made it work. Are they able to build insurance? How have they been able to, you know, do all of that kind of stuff? Right. And anyway, so that's just like a side note, but I wish that that, and I think the the thing you said about academia, in my own personal experience, I would agree with that, that there is a disconnect, like a lot of leadership, especially within counseling, is through like let's say you having a PhD in counselor education and supervision. Right. And if folks aren't aware, I'm a PhD dropout from a CES program due to a lot of frustration with, I felt like a complete disconnect with the realities of the field. And I feel like there it in the training, I'm seeing a disconnect with the field, which is just being perpetuated in these programs. And so I love that you named that. And I would like to just kind of put the call out that folks listening to this, if you are in leadership positions, you know, how are you engaging people in the trenches and actually listening to the realities instead of these sort of loft, like you said, lofty ideas about how you know how things work versus the reality of the systems that we're up against and that we're facing exactly the things that limit people from getting what they need. Absolutely. So, one thing that you said to me that I really want to explore with you that in our pre-interview you brought up, which might be controversial, let's use that word, but I love it, is in talking about insurance and kind of fighting back against insurance, you talked about getting clients involved in that process and pulling clients, you use I'm gonna quote you, pulling clients into the rage. That's what I wrote down. And I think some clinicians are really hesitant to be transparent with clients about insurance issues because they feel like it crosses a clinical line or clinical boundary, and they don't want to, they're concerned maybe that it's gonna get in in between in the clinical relationship, that they're whatever. I'm not even sure how to phrase it. I'm really curious because I love it, and I'm curious how you have done that in a way that feels appropriate and kind of your mindset and like how you look at that work. Because I I thought you you specifically mentioned that, and I I'm very curious about it.

SPEAKER_00 20:24

Yeah, absolutely. I mean, so to to kind of give like a background, right? I mean, we're both here in this advocacy work, and and me being here, one of the main reasons I'm here is both for my employees and then our clients, right? Because we're both everyone is harmed by this system. Everyone, right? Because clients are paying high premiums, but then they have giant deductibles or limitations or carve outs or insert insurance buzzword here that makes it difficult to use your in your benefits, right? And like they're not easy to understand, right? I encourage clients to try to understand their benefits better, but at the same time, it's it's fucking hard. It's hard, you know. And I mean, even as someone who also has insurance, I read through and I'm like, I know these things from my side, and I'm still like, what the hell is this?

SPEAKER_03 21:20

Right.

SPEAKER_00 21:21

Talking about, you know. So, like just in building my practice to start, I was already very transparent of like these, this is what insurance can do for you. This is what insurance cannot do for you. This is where we are beholden to insurance, this is where insurance might not be beneficial to you, all of that stuff. But what I noticed is uh I always say uh insurance companies like to play games, right? They they mess around, they tee, are we gonna pay you or not? And so I uh I like my hands are sometimes tied behind my back whenever I'm ready to do things. I will frequently tell clients that insurance companies are more transparent with with policyholders than they are with providers because they are you are giving them money and I am taking it away. So like they want your money. So they are going to do what they need to do to make you more happy as much as possible, at least in communication, right? Compared to me, they're just like, I don't care, right? Figure it out. And so we've noticed over the course of my practice, like how long I've had my practice, that insurance companies are getting less and less transparent, more and more complicated. And the, you know, there were some companies that were better than others. And now it's like flip-flopping and getting crazy. So basically the the way that I like to look at it is just since we're all getting hurt by this system, right? I am never disparaging an insurance company, right? I'm never calling names or do but I am not lying to our clients. Right. I'm not I'm not going to cover for your shenanigannery.

SPEAKER_02 22:58

Oh I'm gonna I'm gonna steal that word shenanigannery.

SPEAKER_00 23:02

It's one of my favorites like I'm not going to to lie and say like oh well we don't know no no if you like one of the one of our companies I won't name really loves to deny based on coordination of benefits which if people listening don't know what that means basically your insurance company decides you must have another insurance plan. And that means that they are not the primary plan and they don't need to pay. So just out of nowhere both denied claims and also clawbacked claims they just say I don't think we were the primary I think you need to build the primary and I can tell you nine times out of 10 when I reach out to that client and I say hey do you have another plan? You know, did something change nine times out of 10 nothing changed. Nothing no new jobs no new kids no new parents like nothing and they're like I have no idea why this is denying now and I say yeah because it's shit anaganry they just don't want to pay and honestly especially in those instances right I noticed in talking to clients that they were getting frustrated with me and I'm like hey hey I'm not part of this equation right I just want to get paid for my work and I want my employees to get paid for their work. That's all I care about right and so I started noticing that if I just was open and honest with the clients A they would be pulled into the rage as I said without me doing anything right I'm not trying to make them mad. I'm just telling them unfortunately your insurance company likes to play games around this that and the third I don't know why who knows right I also think that just in our current climate clients are much more likely to get mad in that direction right because people are are sick of this the systems that are not serving them. And so I'll have clients come in and they'll they on their own will be like my insurance company is stupid and I'm really sorry about that. I'm used to it right so it's it's something that I I do because I honor the clients autonomy. That's the word I value their autonomy I value their choice um I want them to be able to access the benefits that they are paying for they are owed based off of their premiums. And also I don't want my therapist to have to worry about that. That's part of why I built this practice like you don't have to do the whole back and forth of running a business because you that's not what you want. That's why you're here. So I pull clients in because A, sometimes I have to like that sucks, but sometimes I have to but also just to say like this is why we are having such a difficulty and I've noticed that early in my career there was a lot of and I think there still is but maybe to a lesser extent a lot of people commenting oh therapy is too expensive these therapists are making $200 an hour what more do they want and all of those like comments and I think this advocacy like and pulling clients in is like pulling behind the curtain and and say no no that's not how it is actually you you've been fed a bunch of lies.

SPEAKER_01 26:12

So yeah because even if we were billing 200 we're not getting 200 I mean some people are you know I know in like rural in a lot of like low provider areas like in like Alaska and stuff I've I've seen some of the ranges of reimbursement rates that they get and I was like more I was like Jesus Christ the cost of living here is twice what it is there and I'm paid half what you're paid. So yeah and so I think people don't understand and you also bring up I think a really good point around or at least you you didn't necessarily make this point but it's kind I I went there in my head as I was hearing you talk, which is that being part of a group and I talk about this with the clinicians that work for me is getting in these conversations with clients can be challenging when you're you're the clinician and like you're wearing all the hats. And so I have an in-house biller who I love and preventing clinicians from having to put that that billing hat on and deal with the money stuff and go over insurance benefits I think is so it it puts like a nice guardrail I think around that therapeutic space while also have being like while also helping clients understand what's going on but separating it from the clinical work. So it just it made me think about that while you were talking that I think that is one of the benefits of a group practice and absolutely you know to bring in the whole VC crap is I'm gonna have I don't know what the order of release of podcast is going to be but uh Susan Frager who is known as psych billing coach if anybody knows who she is she's amazing. She actually sent me an article this morning around Alma and the way that they're billing stuff and not being upfront about it was this great article I'll try to link it on the podcast or on the uh website where they were promising they kept con they kept like telling this client different things. The therapist was getting involved in it but then was being left out of conversations about it. And like the therapist is in this position where they have no control over what's going on and they're being kind of looped in and this client was like you told me I had a $10 copay but now I'm being charged $127. Then you told me that oh oops but you you you have a wave deductible so yeah and then they're getting billed and then the therapist is like in the middle of all of this with no control like nothing and what a nightmare as far as like maintaining a therapeutic relationship. And then Alma's like well we can't give you anything because we're not we're not a covered entity. We're we have we have a business associates agreement blah blah blah I wish I had the article up front I didn't think that we'd be I didn't think that this would be popping into my head right now. But that it's another reason that I think these VC backed platforms are so unethical and compromise the work that we're doing because it you know in my practice and I'm sure for yours as well like if there's an issue I we investigate it and we take a very client centered approach to how we deal with it, how we resolve it, maintaining the therapeutic relationship, maintaining the relationship with the practice and these big companies they couldn't give a shit. They don't care. They don't care it's the bottom line that's all it is yeah and clients are a dime a dozen and therapists are a dime a dozen and if it whatever they're still gonna bill you they're still gonna charge you and there's still a line of more people waiting to get clients and waiting you know all of that and clients waiting to be seen. And so anyway when you were talking about that it just made me think about how even with insurance and billing and how I don't want my clinicians to really be involved in that as much as possible how having a practice that is committed and have that personalized approach benefits everybody especially dealing with my word is fuckery dealing with the fuckery of um of how these insurance companies operate.

SPEAKER_00 30:35

Absolutely absolutely I mean I think that's one of the reasons I came this direction is working in community mental health that was one of the benefits right I'm completely separated from billing from anything because that was just not my purview. And then coming into solo practice I was experiencing what you're describing that like dual relationship of like biller therapist and I know there I'm sure there were plenty of people that left because they didn't want to confront like money anxieties and things like that completely understandably right no shade from me. But it's harder when you're having to occupy both spaces and I I tell my therapist all the time this is not to hide anything from you. I'm more than happy to share these details with you. But also this is so you can just focus on the clinical work right I get to be the bad guy and coming in and saying hey you actually owe us money I'm so sorry you know that way you don't have to worry about it and then the relationship is preserved.

SPEAKER_01 31:33

And you have the opportunity you know if you're in a model as a practice owner that is client focused and you know really thinks about these things like if if there is an issue where I don't know let's say there there was a billing issue or the insurance labs or there was something where all of a sudden we're realizing that the client needs to pay out of pocket. My biller will contact me and say how do you want to handle this? I'm gonna reach out to them these are the options that we can do and we can take a very measured and thoughtful approach and put people on payment plans and speak with the clinician and say hey this is the situation. Right what are your thoughts yeah are you comfortable with this I'm happy to offer them the contracted rate of the insurance that we thought they were gonna be using instead of our full fee da da da da this is how far they are behind. I would like to pause if if we can't get some payment now can you are you comfortable communicating that with them exactly all of those is it safe for us to pause right now like all of those humanistic things that we focus on balanced with you maybe you have to eat. Yeah you know but Hedway's not having those conversations I'm sure Alma's not having those conversations I'm sure there's handout yeah please there's and and I I want clinicians to be thinking about that aspect of this work in being aligned with these companies because at the end of the day it's gonna impact the relationship with you as the clinician right when people feel like a commodity or like just a consumer and not a human. Exactly exactly that's a perfect way to put it yeah so gosh there's I could talk to you all day I love this I say that about so many people I just I get so pumped when I I am especially talking with a fellow small group practice owner on it feels like I I can speak for myself and I'm curious about your thoughts that I'm within my mission of my group practice it's also about trying to prove a point about how things should be done right like the success of my practice I feel like I want it to be successful because I I want to take I want my clinicians to be financially stable I want them to have a positive experience in this work I want them to have sustainable careers. And I also like I said earlier I want to work at a place that I want to work at and I realize that the only way to really do that is if I just run my own business. But I also think that it's also how do I want to put this it's almost like I want to it's almost also a way to push back on these systems to demonstrate how things should be done. Like if that makes sense that it's it's also almost part of my advocacy work to operate a practice like this and to scream from the rooftops on how I believe practices, group practices should be run.

SPEAKER_00 34:55

Right. No, I agree with that and it's it's it's something that so I you know I'm in Erie which is a low cost of living area but also a rather poor area unfortunately and our reimbursement rates I feel uh reflect that you know and so like what you're saying of trying to really push back against the system in creating a group practice that is modeled well I definitely feel that is a core mission of mine just because I completely understand the safety and stability of community mental health because for for context most community mental health agencies in our area are owned by insurance companies yes so they feel mad oh believe me it's it's rage inducing and I I try I mean when I interview clinicians I say listen I completely understand that like you can get a salary you can get consistent clients you can get health insurance you can get all these other things there you will also be worked like a dog and expected to do whatever they say so like up to you what's important right I will always be forthcoming and say I understand that I cannot compete with these big dogs right I am not a multi-billion dollar company but what you'll get here is respect right and and kindness and more control over your caseload and who you see and when you work and all these other things and better pay for crying out loud you know like for at that but at the same time because at least in our area reimbursement rates are so low I talked to lots of other group practice owners and it's like we can barely get our feet off the ground of like growth and helping to take care of our clinicians right my ultimate goal was to create kind of what the agencies can give obviously to a lesser extent with you know benefits and and time off and all these other things and that's kind of what's slapping me in the face right now which is again coming back to advocacy work one of the reasons I'm I'm in these organizations trying to reform because I'm looking at like the numbers and saying I can't I like I can't afford to take care of these people the way I want to you know and they they deserve it they they do great work they show up every day I mean you and I I'm sure we we were in solo at some point so we know how hard it is to just clients clients clients clients clients all day right I want to take care of them I want them to be safe and stable and and have secured careers like you just said I want to teach them I want to to provide a community where we can learn new things and build off of each other and then I look at the numbers and I go are you fucking kidding me pardon my language like I can't do all of this because I don't have the money right and this is just basic what many other people take for granted out of their workplaces right they can get benefits and time off and things and like I can barely provide that for my people because you people won't pay us more than a pince. Sorry I'm mad about it.

SPEAKER_01 37:55

No I mean and it's true and I I I feel like I've been very fortunate in the way I've been able to strategically build right but I also recognize that without the network that I had and people that put trust in me early on who closed you know fully licensed people closed private practices to help me get off the ground. Wow right that yeah uh I I there's no way I would be where I am right but that also speaks to the nature of building a strong network developing a reputation and being somebody that people can trust and developing that and taking the time to build that in the field in your community. But also then it's like and I hear you because you have six clinicians including I mean that includes yourself and an intern, you said I have 10 clinicians including myself and an intern. And I also have to we also have to think about well the more people we hire the more stable the practice becomes but at what point do we lose the community and culture which was the point of building the practice right it's like and I'm I'm very transparent with my clinicians about it. I'm like okay so there's 10 of us 11 with Jody my lovely biller who I adore and I'm always telling them hey like I want to be really intentional about growth. These are the things I want to be able to offer you and I'm always crunching numbers and I'm like one if we have this many clinicians that once people are full that gives me the flexibility to offer this additional benefit right like everything is part of that. But I also want to be really mindful about I don't want to be a huge practice. I have no desire I was clinical director locally of a practice that had 50 clinicians in a country where I was like I don't even know everybody's name like I can't keep track of all these faces and it was impossible to maintain culture and it just started feeling like another corporate thing that didn't care. So I think you bring up this great point of how practice owners at at our level are kind of caught between a rock and a hard place with you know having all the good intentions and doing like what we do with scraps I think is amazing. Absolutely but being put in a position where to be able to compete with these larger players we have to become a larger player ourselves with then which then defeats a lot of the things that we're trying to do in the field.

SPEAKER_00 40:24

It's like it it feels it sometimes feels yeah like you know it's it's we we want these things and it feels like we're we're I often will an analogy I use with clients is up here in the snow where like you've driven in the snow and it's fresh and everybody's like driven in the same rut. And so your car just kind of gets pulled to that rut, right? And so that's what it feels like is like we're trying to chart this new path of being a small practice and taking care of our people taking care of our clients like good ethical uh values driven practice and then like headway alma all that comes across and it's just like nudging us into the rut of like be big be huge right to you need to to compete and I'm just like no I'm I know like I don't know that's that's my soul.

SPEAKER_01 41:18

It's the same way I feel and I know state to state there's different nuances around 1099 versus W 2. Oh god yeah I could talk about that all day I have feelings uh let's say about 1099 I'm gonna be honest when people say they have a 1099 group practice I'm like that's not a group practice stop calling yourself a group practice because that's not a group practice you're an MSO. Just call yourself an MSO because that's what you are. It's not a group practice because I I and I don't want to piss people off with this but um if you're contracting with people who basically then are running their own private practice and you're doing admin and billing you're not a group practice and they are not your employees. And I think that and we could do a whole diatribe about how I think headway is crossing that line how I think almost crossing that how a lot of these companies I feel like are crossing the line I pick on headway a lot but I there's a lot of creep. There's a lot of creep in how much control that they want to have but I I get frustrated when I see 1099 MSO practices let's say want to have employ like treat people like employees and have these expectations yet aren't like in Washington state I've been told basically if if you're hiring therapists it has to be a W-2. Yep and I'm fine with that. I feel like it honestly it creates a sense of like commitment to what we're doing like you're part of this. Exactly I agree. And then I see practice owners wanting people to feel that but they're not employees. Exactly and and I think that again the reason I'm bringing this up is because I think that it's the only way that I think practice owners can feel like they can compete with these larger entities financially because if they're not paying benefits, if they're just you know kind of streamlining admin work for people, it's you you're paying less, right? Like they're not paying payroll taxes. They're not thinking about sick time. They're not looking at okay can I afford a group health insurance which my small practice we just launched in 2026. When I saw that like subsidies were being cut I started to panic and was like all right let's do this right so I'm covering 50% of premiums if people see so many clients per week and I'm trying to expand that I feel like I'm I'm seeing this frantic like how do we compete? And I think you nailed it in that you know we may not be able to compete In some ways. But when I think about sustainability and support and not feeling like you're in a silo, I think, especially with the current political umbrella that we're all under right now, if you're a marginalized clinician working with marginalized clients, I'm concerned if you're working solo. Like I'm be honest. I'm concerned if you are working for Headway and just client, client, client, client, client. Unless you have done a very, very good job of making sure that you have consultation groups that you're going to and that you are maintaining those ties, which I think a lot of people aren't able to do, or they get burnt out and it feels like another thing that they have to do. Right. Exactly.

SPEAKER_00 44:50

Another checkbox.

SPEAKER_01 44:51

Yeah. So I get concerned about just the sustainability of this field when it feels like I call I call the VCs like therapist farms. That's I've coined. I love that term. Yeah. Um and like, what does that do to the field in the long term as far as working collaboratively, like that ongoing learning and training? Because they're not taking interns. And then I'm like, so if we close all these group practices and everybody's working at headway, where are interns supposed to go? Like we're losing out on opportunities. I mean, sure, community mental health, but there's only so many spots for that. Exactly. And then it continues to exploit interns where they're seeing high acuity folks while they're in school, and then they can't get credentialed through headway. So now where do they go? Where do they go?

unknown 45:51

Yeah.

SPEAKER_01 45:52

Where do they go? Exactly. Exactly.

SPEAKER_00 45:54

It's I've I've heard of you know various community mental health uh across, you know, from a lot of different people that some of those places are not wanting to take new licensees now because they don't want to commit time to supervision and like the liability of them. So then it's just it feels like their opportunities are just cut, cut, cut, cut, cut. Wait, who's saying that? Who's who doesn't? I just heard other, you know, just like rumors and whispers, right? Of like, well, that my local, you know, committee to mental health prefers not to take, you know, unlicensed folks because then they have to pay for supervision. Or on the flip side, if they take them, they're exploiting them even more because they're saying if you stay here and we help you get your license, then you have to stay for X amount of time, which is say it with me kids, blatantly illegal.

SPEAKER_01 46:39

Like they're doing, I didn't even know that that was happening.

SPEAKER_00 46:42

Yeah, yeah. That's that's something that I've heard from a number of people that they're trying to get them to sign contracts to say, well, because we're helping you get your license, basically, like you get the benefit of like free supervision since they're not having to pay you for it, but then you have to stay for X amount of time, otherwise, we're gonna charge you for like all of the supervision received. That's crazy.

SPEAKER_01 47:03

Yeah. I've heard that about a local MSO that I will not name. Um, but if you're in Washington, you know exactly who I'm talking about. Everybody knows. And I heard, and this is just what I've heard, I cannot confirm. This, thank you. Allegedly, if you sign up with this particular MSO in Washington state, uh, you sign up for a two-year contract. If you terminate that contract within the first year, you owe them $5,000. I almost dropped dead when I heard that. If you if you stay a year but don't complete two years, I think you owe them $2,000 or something like that. I may be getting the numbers slightly off, but I was absolutely mortified, absolutely mortified when I heard this. And it's it feels very aligned with what you're saying, but in like community mental health, and that's community.

SPEAKER_00 48:01

Yeah, I mean, owned by insurance companies, from what I understand. But yeah.

SPEAKER_01 48:06

And I I'm trying to figure out how an insurance company can own a community mental health.

SPEAKER_00 48:10

That's a really good question. And I wish I had the answer to that. But yeah, I mean, that's it's they they sponsor, right? The nonprofit, however they, whatever the legalese word is, right? That they've like absorbed it. Something that a lot of people, and it's it's normalized here. And so talking to people and seeing their expressions when I tell them that like most PCPs around here are owned by like practices are owned by insurance companies. I can probably count on one hand the amount of PCP offices that are private and and not owned by an insurance company in in our city. And for us, it's like, yeah, that's what it is. But then I talk to people like you, and like, oh, maybe that isn't normal, actually.

SPEAKER_01 48:49

Well, I think it's becoming I think it's becoming more normal. And I'm curious because I have another upcoming guest who has a huge multi-state group practice, like huge, huge, huge and has is having issues with insurance companies, and we'll be talking about all of that when I have her on the show. So one of the things I've been hearing about more and more are insurance, speaking of insurance companies and their overreach, is telling either individual providers or group practices that they need to contract through Headway in order to get a contract. Have you run into any of that or heard about that in Pennsylvania?

SPEAKER_00 49:30

I have not, but I'm not surprised, unfortunately. Very disappointed, but not surprised. It's something I I've heard like whispers of, and it's it's so hard to tell what is and what isn't because like they're definitely doomsayers, I think. Like they go too far and they're like, the world is going to end because all of these things are happening. And so I try to measure what I'm listening to and what I'm believing to try not to be like reactionary. But definitely in my practice, and maybe it's just because I got started kind of before her headway, you know, or before headway got really the same. I think that might be it, actually.

SPEAKER_01 50:01

And I secured my contracts before we're like completely bad shit crazy. Yeah.

SPEAKER_00 50:06

Right. I definitely hear a lot because like over like the Philadelphia area, there's a lot of private pay. And so from what I've understood, is a lot of folks down there who decide to take insurance out of it that way because they like they they don't know how, you know, they they've never needed to. Meanwhile, in Erie, right, we just kind of come up and we're like, yeah, like we take insurance. Like again, I can count on one hand the amount of people that are private pay solo here, and they are super duper duper duper duper niche. So it's just we all understand, yep, this this is what you do. You take insurance, this is what that looks like. And so yeah, I've avoided that and I hate that. And I really hope it never becomes a thing because I will have some uh choice words for them.

SPEAKER_01 50:52

Well, it it it the reason I was thinking about it too is because when you were talking about like insurance companies being sponsoring community mental health, and we talk about, and people have heard me talk about uh what we call vertical integration and the vertical consolidation, which is more of the umbrella of what's happening. But vertical integration being that let's say a health and insurance company owns every rung in the ladder, basically, right? So in community mental health, if they are a sponsor or an investor or whatever word you want to use, and their insurance is being billed, they're basically paying themselves by investing in something that they're gonna then get a payout, which I don't even understand how that is legal. And it's not, in my opinion, it shouldn't be, and it is it shouldn't be. I don't know, it is, but it shouldn't be. It is, but it shouldn't be. And then hearing about, you know, insurances investing in these VC platforms, like headway.

SPEAKER_00 51:52

That feels like it should be illegal or is.

SPEAKER_01 51:55

I don't think it's it is, but and that's the thing. It's like we have we have these laws and there's no enforcement, it feels like exactly yeah. And it's because I have heard, so there's like the investment piece, and then I've heard in multiple states, like in Mar, the two states I've heard about from people specifically with their personal experiences, one of them is in Maryland, at least one or two of them are in Arizona, where they've been told by the insurance company, by the insurance company to contract through Headway.

SPEAKER_00 52:26

Yeah, that feels like blatantly illegal. Like that feels like if it's not illegal, it is like this delicate dance of a loophole. That's like, how did you even figure that out?

SPEAKER_01 52:37

Mm-hmm. And locally, talking about insurance is sponsoring like community mental health. I know that there were two practices in Washington State who were bought out by Optimum UHC, United Healthcare, and within a year or two, they shut both of them down. Like, what does that tell you? What are they trying to do? We know what they're trying to do.

SPEAKER_00 53:02

Right, right. They're trying to close everything down so that there's scarcity and then they can come in and be the white knights.

SPEAKER_01 53:08

Yeah, right, save the day. And people rush to these therapist farms because they're scared.

SPEAKER_00 53:14

Right, right. And I know people get sick of me, and I'm sure you've like whenever somebody is like, Oh, you know, I think I've been in contract with Headway, I literally like jump in front of them and like, don't do it. Like, there are people that I've I was like, I will credential you myself for free before I let you join Headway. Like, listen, I know there are reasons, at least around here. I know other places, maybe there's huge disparities in rates or something like that. Around here, people just do it because they don't feel like dealing with it. And like, I will, I will credential you. Hell, pay me $20 a month and I will do your billing. I don't care. Like, this is like a labor of love to me. Or like, please don't. Please don't. Very close friend of mine just said, I think I want to start a group practice. Which of these platforms should I join? None of them. None. Please, none. Don't do it. Please tell me you didn't start. Thankfully, Sheanne. So I'm sure people get sick of me because in Facebook groups, in person, anywhere, you know, somebody says, Well, what about headway? I I go on a long diatribe. I know you've said that word, uberization of therapy. I've used that term myself too. Or I'm like, they're going to suck everybody up and then they're going to slash the rates. Because why I always say critical thinking, guys, right? Like, what interest would insurance companies have to pay us well in the current climate, in the current state of things, right? Why do you think they would want to do this? Why do you think they would invest in platforms that are paying us better?

SPEAKER_04 54:45

Mm-hmm.

SPEAKER_00 54:46

Because I promise you, it's not out of the kindness of their hearts, because they could do that a lot easier than investing in these platforms. Right? Yeah. Like just think for a moment who who is doing this and what their primary interest has always been. It's not us.

SPEAKER_01 55:02

You know? And then you hear rapid credentialing, you hear higher reimbursements. I'm like, you're showing your cards there, Hedway. Why are you getting higher reimbursements than everybody else? Please. And we know why. And then going back to what we were talking about earlier, what I don't think people realize is I'm just gonna throw out arbitrary numbers here. Okay. Yes. So let's say Headway, their Blue Cross Blue Shield, they've been able to negotiate for 90837 $300 for that code. What happens to that client who hasn't met their deductible? Exactly.

SPEAKER_00 55:39

Yep. I have heard that too. People are getting charged so much, and the therapist isn't getting it. And now they're like, well, I'm paying 200x a session.

SPEAKER_01 55:50

And then the clinician is getting 120. But the the client's being charged 300 or 250 or whatever it is. Right. And how is that impacting the therapeutic relationship? And he's left in the dark. Yeah. And doesn't that piss you off? Like, how are they getting and again? I'm making these numbers up, people. Right. So don't quote me. But I do know that their contracts, some of their contracts are much higher for a reason. And it's gonna impact the your relationship with that client when a client gets a bill for $500 for two sessions and is like, wait a minute, what the hell is this? When they could have seen somebody else and not paid as much. And keep that relationship intact. And you might be making $10 less a session, but that client's gonna come back because they trust you. Exactly.

SPEAKER_00 56:46

Exactly. Yeah, I mean, that's coming back to like bringing clients in. I mean, that that's the perfect example of everybody's left out of the loop, right? Therapists have no idea how much these platforms are charging, how much they're actually pocketing. Uh, clients have no idea that the therapist isn't getting all of it. And that's where like I I said before we even started recording that I do think therapists are super capable of making change. And I think there's so many of us, and and we're growing by the day of people who are just sick of this and are ready to take action. But I truly think that you know, part of why I bring clients in is because I think that them joining this fight is something that will truly make a huge difference. I mean, when when people's insurance companies treat them like shit, I say, call up your HR company, right? Call up your HR rep and tell them this insurance is shit. And if enough people do that, then maybe the HR company will say, ah, you know what? Actually, we have a lot of people complaining about the insurance panel. Maybe we should find something else.

SPEAKER_04 57:46

Right?

SPEAKER_00 57:46

Because like we can opt out as much as we want. These people are still making money hand over fist over fist, you know, regardless. But larger companies, right, saying, Hey, our uh employees are actually really dissatisfied. Um, that's something. So Cigna uh is a plan around here that's not super widely taken for that reason. Because around here they're known as being difficult to work with. Most providers don't take them, clients complain to their employers, and so there's not a lot of employers that take that that have Cigna anymore. So, like, this stuff works. It works to enrage people. So, I mean, not purposefully, that sounds really bad coming from a therapist. I'm enraging people, but like I tell them, you know, I'm here to advocate for you, and I want to help advocate for you. I can't do it all by myself. I wish I could, but I can't. Like, you gotta be here with me. We'll we'll find out.

SPEAKER_01 58:37

Well, I think you're also empowering, you're empowering them to understand right the system itself and what they can do to advocate for themselves.

SPEAKER_00 58:46

Exactly. I think that's what a lot of insurance companies and maybe you know, some of these VC backed companies too bank on. I think you've said it in episodes prior, is they hope that you'll just give up, right? But it's too confusing and you'll just give up. Like, I'm too stubborn for that. No, thank you. I'm I'm going to figure it out and I'm gonna help them figure it out.

SPEAKER_01 59:06

No, I love it. And you're actually giving me ideas from like, maybe I'll add a page on my website on like how to advocate for yourself with insurance or whatever. You're like, my my brain is all like, hmm, I love it. I love it. How can I bring my advocacy more on the client end within my group practice and even just outside of the therapist unchained stuff that I'm doing? This is why I love these conversations because I get ideas. I'm like, ooh, that's really interesting. How do I explore that too? And we're just about out of time. I feel like we are with this conversation's gone all over the place, but I think it's all connected to like, I mean, it it speaks, I think, to the complexity of what we're facing. Yes, that we can have a conversation like this and it can branch out into so many things. And that is part of the web. I want people, right? It might feel a little disjointed, but it's not because it's all part of the same beast. And understanding, I always joke that my brain is like one of those murder boards with like pins and strings, like right. And I think this conversation is a great example of that. Sure, we can be talking about this one little thing here, but oh, that's connected to this over here, and then that's connected to that over here, and then these people have a relationship here, and then how does that impact this over here? And then, right? And so it's not disjointed, it's demonstrating the complexity and the integrated complexity. There's so much to think about about what's going on, and that there are, like I love that you said, like, huh, heck, I'll help credential you. I've had people on the podcast where they do this, they help people, they have groups. I actually explained credentialing on one of the episodes where I was talking about how credentialing and contracting are two processes, it's not one process, and to understand what happens in each process, et cetera, that people can do this. I have done business consulting with a number of clinicians where I don't do it for them, but we screen share and I'm like, all right, here's how you fill out this. I want you to do X, Y, and Z, get that done, and then and maybe we meet twice to help them get off the ground. I charge $150. So to get all the knowledge and learn how to do all of this themselves, maybe they're paying $300 and now they're empowered and they know how to do it, and I answer questions. They can still shoot me an email if they're confused and I'll respond to them. But I want them to feel empowered to do it.

SPEAKER_00 1:01:34

See, now you're giving me great ideas because I was always just like, I'll just do it. But that's so that's so much better. That you know, I want people to feel yeah.

SPEAKER_01 1:01:43

And I had one person I remember going, she was about ready to cry at one point. I was like, girl, you've got this. Remember, you only have to do this part once, right? Let's like we were, I was getting her into a vality or something, and her head was exploding. I was like, dude, you only have to do this once and then you're done. That's it. Like you can get through this. I, as a group practice owner, have to continue to go in as I hire people and go through. Right, more and more and more and more. But like it's a one and done, and then you're good to go.

unknown 1:02:11

Right.

SPEAKER_01 1:02:11

And I'm here for it. I've got you. So yeah, I want to empower people to learn how to do this. Once you learn the game, it's not hard. It's just, did I dot every dot I and cross every T? And do I know when to push back and say, hey, wait a minute, uh-uh, that's wrong. And like, you know, engage because they mistakes can happen. People can not respond to how they're supposed to. So, and you know what I'm gonna ask somebody to do? Because I've been thinking about doing this. Somebody needs to create a custom Chat GPT or clot or whatever one you do that is sourced with like every state's credentialing and contracting laws and processes or what wouldn't that be great? And like billing, like a mental health, like customized chat GPT that we can feed all of the data into and can help people like extract the information that they need. Wouldn't that be great?

SPEAKER_00 1:03:06

That would be amazing.

SPEAKER_01 1:03:06

Wouldn't that be amazing?

SPEAKER_00 1:03:08

That would be. I I talk often with colleagues about how I want something like that, but for like insurance checks so we can like roll it all together, like oh yeah, for for credentialing, billing, all this stuff, so that I can check insurance and it'll say like primary this, secondary this, all of that.

SPEAKER_01 1:03:24

Wouldn't that be great?

SPEAKER_00 1:03:25

Oh, that'd be amazing.

SPEAKER_01 1:03:26

It would be amazing.

SPEAKER_00 1:03:28

This is the kind of stuff that we dream of as practices, right?

SPEAKER_01 1:03:33

So so dorky.

SPEAKER_00 1:03:35

But anyway, yeah.

SPEAKER_01 1:03:36

Because I think that it like the complexities and the confusion and it's different state to state and da da da. It's just it it overwhelms people and having a source. So, folks, like if you're listening to this podcast, I've had a number of people on who, myself included, that will help folks learn the credentialing process, will walk you through it. Um, and there are a lot of groups out there, therapist-owned, that do this kind of consulting work, even if I haven't had them on the show. You can like look for folks in in the therapist groups, maybe that you're in online to see who does it, who and who's committed. You don't have to do this on your own. And yes, those people should get paid for their time. Thank you. Yes, right. And in the long run, paying someone to help you navigate this is gonna cost you less and help support other people in the field versus letting Headway do it for quote unquote free, but you're still paying for it. You're still paying for it.

SPEAKER_00 1:04:38

Exactly. $300 for your clinical freedom, right? You can do what you want to do, go where you want to go, own what you want to own client-wise, right? It's so much better. It's yeah, it's it's not as scary as it seems. Yeah, I was terrified when I started. It's it's I had the help of a very good colleague and now friend. So I'm here to pay you that forward, and I'm sure there's so many other people too.

SPEAKER_01 1:05:06

Yeah, and I will have your info in the show notes, whatever you want, so you uh whatever you want to have listed in there for people to be able to get in touch with you. If this is something that in your area you're willing to kind of build out and help people navigate on a more like, and it sounds like that's something that might interest you. So reach out to Jessica uh if you're in Pennsylvania, and she's probably gonna be able to help you out in learning this stuff and support her practice because it sounds like she's coming from the right place. So if you're looking for a good referral opportunity of like a place to send clients that maybe aren't a good fit for you, check out Metamorphosis Counseling in Erie, Pennsylvania.

SPEAKER_00 1:05:48

Thank you.

SPEAKER_01 1:05:48

And Jessica, any final words before we wrap up this lovely conversation?

SPEAKER_00 1:05:53

I mean, this was so awesome. Like I you said earlier, we could talk about this all day. I love like-mindedness and just like the shared rage with all of this stuff. It's it's cathartic. It's cathartic. But yeah, I mean, I guess the final thing I would say is just this is the system is not broken, the system is working how it should. So let's let's break it, right? Let's let's make it work for us.

SPEAKER_01 1:06:17

Yeah. When you said that, it reminded me of like I've never had a broken leg or whatever, but they have to reset it, right? They have to kind of re-break it sometimes. I might be getting it wrong, but but that's what came to mind when you said that.

unknown 1:06:31

Yeah. Yeah.

SPEAKER_01 1:06:32

To make sure that it heals properly.

SPEAKER_00 1:06:34

Right. Exactly. I use that with clients all the time. So it's actually really funny. Oh, did it really? Yeah, I do, I do.

SPEAKER_01 1:06:41

You also said you're stubborn. Are you a Taurus?

SPEAKER_00 1:06:44

I am not, I'm a Pisces. Oh, okay, just checking.

SPEAKER_01 1:06:47

Just checking. Because I'm a Taurus.

SPEAKER_00 1:06:51

We're we're very lofty, lofty dreams, lofty goals, stubborn over here, like head in the clouds. So brings me to the advocacy, right? This isn't how it should work. And it should work differently. So I'm gonna make sure it does.

SPEAKER_01 1:07:04

You're such a joy, and I'm so glad that we met and that we will be continuing to work together through the task force. Yeah, that I will continue to learn and work with you in the future. So I so appreciate your interest in being on the podcast. Thank you so much for having me. Jumping in, and I want to thank all of my listeners for sharing the podcast, liking it, reading it on your preferred podcast platform. I wanted us to be getting the word out. This stuff is vital for clinicians to understand how all of this stuff works. So I really want to thank everybody for their support and continued listening and folks that are sharing this with their colleagues. Thank you so much. I really appreciate it. And again, my name is Civy Suckerman, and this is Therapist Unchained.