From nothing to something: Beginning of an organization

Posted in Newbies: Posts for early career therapists, What it is like to do therapy
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The beginning of an organization is a story worth considering. Each has its own history. No two are alike. This is the story of the early history of Centennial Counseling Center’s (CCC’s). I founded and superintended its growth to what it is today. My hope is that by sharing this ancient history we might increase our understanding of how CCC became what it is. More importantly, I hope it is a useful case example.

Here is something to ponder. I personally have provided about 35,000 hours of therapy over my whole career. In 2018, CCC will be close to providing that same 35,000 hours of therapy in a single year. While CCC may have developed out of my individual clinical practice, what it can do far exceeds everything I could do in a career as a solo practitioner.

The beginning of an organization

It begins with my solo practice. I have shared some of those early experiences here: “From nothing to something: The beginning of my practice.”

In those first ten years, I did not have a fully-formed idea of what a private practice was or could be. And as that vision morphed and responded to the changing mental health climate, it eventually grew into the vision of the CCC that we know today.

Why I did it

I was not too far into my early years of practice before I discovered how lonely it is to do therapy by oneself. My clients were great but they did not fill all my needs. I began to think about something larger than solo practice. My first vision was to collect a handful of people who would join me, sharing the space I was renting and help with two objectives—meeting needs in the community in a way that was similar to my style and then giving me workmates who could help with my loneliness.

I have some old notes from the early 1990s where I lay out some goals for myself and CCC. They were all about finding others who would do good therapy and help with the emotional load of the practice. Fortunately, I did find some people who were willing to join me even though I could offer them very little—basically an office space and a name. That was the foundation I offered for finding referrers and building a caseload. I was not able to even offer them many new cases because I did not have them. While I was busy, I did not know how to help others build a referral base. I only knew my way of doing marketing so some of them struggled. (To read more on what became a systemic way of doing our marketing, read: “A community-based marketing method: Community Connection Plans.”)

Growth begins

Eventually CCC got going well enough that it only took two to three years for someone to join CCC and develop a caseload of 20 to 25 clients per week. At the time that pace was a huge success for us. Now with our current methods, we view that as a very slow pace. We slowly grew in the number of sessions we provided the community and in the number of staff working at CCC.

Following is a table of some numbers from CCC’s 12th through 26th year.

Things I notice from these 15 years of data

  • We hovered around 8 clinicians per year from 1994 to 1998 (in red). In these years, we did not add many new therapists even though each therapist we had was getting busier and overall sessions were going up a little.
  • In March 1999 we added the Sandwich office and a year later, the Yorkville office. Adding these offices grew both our staff numbers and our sessions.
  • We leveled off on sessions for 3 years, 2004, 2005, and 2006 (in red). We needed to change. Adding staff was clearly not enough. We needed a program to help clinicians do the right things to grow our referral networks. In January 2006 we added the Community Connection Plan system, a consistent and systematic way of doing our marketing while holding each other accountable. A year later we were growing again. (See more on this method here: “A community-based marketing method: Community Connection Plans.”)
  • From 2006 and beyond, we have continued to add staff and sessions each year increasing the impact we have in each of our communities.

Lessons we might derive

One of my first impressions, as I have been writing this has been about how long it took to develop the various elements that now almost seem routine.

  • From the beginnings of our organization it took us years, and sometimes decades, to figure out how to:
  • build caseloads large enough to provide stability, first for me and then for all the others
  • invite the right sort of people to join CCC at the various stages of development. It was different types at different times
  • train people to consistently and routinely do the things that lead to our growth and stability
  • build a sense of community
  • build a support staff with sufficient specialization and expertise to balance everything
  • and of course, we were adjusting to the constantly changing mental health system

Secondly, I notice how many parts there are that need to work all at the same time. We needed to develop wide-ranging expertise in order to:

  • provide a valued service to our communities
  • build strong, deep, and diverse referral relationships
  • support each other as we each went through many different challenges
  • respond to the constantly changing demands of the mental health system

As of this writing, CCC has just completed its 35th year since its beginnings of an organization. CCC has come a long way and has grown into a resilient, vital, and impactful organization and community of clinicians. And I am grateful for each person’s contribution to making it what it has become.

Also read:

From nothing to something: The beginning of my practice

Why create another mental health practice?

Our Philosophy for Working in Community

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