Conducting excellent job interviews for clinical staff

Once you have a candidate for employment, you need a plan for conducting excellent job interviews. The superb job interview does not just happen. Mapping out an interview plan increases the chance of sorting good candidate matches from the bad. 

Over my 38 years as an owner, I went through the hiring process with over 100 staff. Most of the hires were mental health clinicians. Some were support and administrative staff. (Read about recruiting potential staff here.) Some were other support professionals such as attorneys, accountants, and financial planners of various sorts. (Read more on hiring a team of advisors here.) And in most cases, we had several candidates for each position so I’ve been in literally hundreds of job interviews. Here is what I’ve learned.

Wait to hire the right person

One of the most significant errors we made in hiring was due to impatience. The situation was always the same. We were desperate to hire people. The need was evident. And we had a candidate, though maybe not quite the right candidate. We let our needs drive our decision. 

Many times, we knew we had made an error within weeks. At that point, we had no choice but to see if we could manage our way to a good place. (Read about managing and supervising in other posts.) If not, then there would be a parting of ways, which is always painful. And then we had to go through the hiring process again.

This sort of error is quite common. In our eagerness to solve the one problem, filling a position, we create a new one, a management issue. And management issues usually take months to rectify. 

After making a few of these mistakes, we learned. Now we are willing to start completely over if our first efforts do not bring in a candidate that is the right fit. Do yourself a favor. NEVER COMPROMISE ON THE RIGHT FIT.

Identify your ideal candidate

When I was beginning to hire, I did not have a well-developed sense of my ideal candidate. I was blinded by my excitement that someone might join me. That did not mean I totally shelved my judgment. Fortunately, I still made some fantastic choices. Unfortunately, I was not very clear about what it took to thrive in my practice. I was struggling to lead an interview that drew out the info I needed to make a good judgment. 

As I look back over my hiring history, I now see that I desired different types of employees at different times. For example, when we had only five clinicians, we did not have an excess of referrals to give to new people. Therefore, we needed to hire those with the drive to market and build a caseload. 

But eventually, a downside emerged. These rockstars had less commitment to staying with us long-term. Those with exceptional marketing and clinical skills only needed to add the administrative capability to leave and start up a practice of their own. Rockstars tend to be more independent, a fantastic quality in the beginning, and less so in more mature organizations. 

As we created a systematic way to teach everyone to market, the need changed. Eventually, we had an overabundance of referrals. The highest priority became finding those who did not want to be involved in the administration a practice requires. They want to see clients. So our job interviews needed to change as well.

We found that many are excellent clinicians who have limited interest in building a practice. They appreciated what the organization gave them. They sought a great place to work with minimal administrative load. So then, one aspect of excellent job interviews then is the ability to find this sort of employee.

The qualities we sought

Excellent first impression

The job interview itself is an excellent opportunity to evaluate the clinician’s ability to create a good first impression. Aristotle said that “well-begun is half done.” I believe this to be true as a psychotherapist. First impressions provide a sense of what clients and referrers will experience.

Self-awareness

Furthermore, when hiring clinical staff, we look for indications of the clinician’s self-awareness, the “conscious knowledge of one’s own character, feelings, motives, and desires.” This ability seems foundational to what therapists do. Furthermore, self-awareness seems hard to teach and is probably pretty deeply-rooted in who each of us is and in how we process life. 

Likability

Of course, we hoped for likable staff, those who could draw us in and were engaged in their manner of speech. If the interview was dragging after 15 minutes, we were not likely to hire the candidate. Sometimes we could not imagine how a session would flow with a real client.  

Expertise

The interview was a chance to discover the candidate’s area of clinical expertise and confidence. Typically, we had technical expertise that we were looking for to fill some gaps in our staff. And there were times when we had a highly skilled candidate who did not match our needs at the time. Sometimes we hired them anyway. And sometimes, we took a pass. 

Coachability

We always looked for prospects who seemed eager to learn, those who were coachable. We did not need everyone to come in with all the expertise required. With the right attitude, we could help them get the experience and training they might need. But we could never teach the right attitude. Attitude first. Skills later.

Personal strength

The last quality that we sought was a reserve of personal strength and resiliency. Seeing clients day after day is not an easy job, especially for the fragile. We hoped to sense or see evidence of the strength required to manage the continuous flow of clients. 

Qualities we wanted to avoid

Too narrow a niche

Sometimes we had a specialty gap. We had a population of clients calling for treatment and not enough clinicians with that expertise. The difficulty is this. If we disclosed the need in our interviews, we found that some prospects would say what they needed to to get the job. Then later we would find reluctance to stay with that treatment population.

The best we could do in our interviews was, yes, to disclose our need but then look for evidence of interest in the resume history. If we are deceived, then we had two choices. We could take a hard-nosed stand. Or we could make adjustments to the cases assigned and look for another prospect. We always chose the latter approach.

Not able to retain clients

We found some who once hired, were not able to retain specific client types. Somehow we missed the limitations in our interviews. For example, some do not do a good job with angry men, angry women couples, borderlines, and/or trauma which can activate the therapist’s injury.

Most of the time, we were able to find enough client types that did fit well to keep caseloads full. And yet, there were times when this limitation became the basis for an eventual parting of ways. For more on our process for firing employees, see this post:

• When we need to fire an employee 

Create an interview structure you believe in

Early in my practice development, I did not have much of a plan. I created a new interview process every time a candidate appeared. Furthermore, I did not have a leadership team to help conduct the interviews. It was just me. With time and growth, the process got systematized and standardized.

As time went on, we settled on a two interview process, each interview with two leaders together. That way, we had the four clinicians on our leadership involved in each hiring decision. 

We had some standard questions as part of our excellent job interviews. We always asked these: 

• Tell us about how you came to decide to become a therapist?
• Can you say something about the supervision experiences you have had that you liked or did not like?
• Can you tell us about a client that you felt you helped? What do you think you did that was helpful?
• Can you tell us about a therapeutic disappointment and why things did not work out well?
• Are their particular types of clients that you work exceptionally well with? Those you prefer to avoid?
• Do you have a sense of what is most important to you in your next position?

There are also likely to be a few questions about aspects of the resume that they brought. These questions are to clarify their work experiences and relationships with supervisors. 

Our probing is to learn about the story of who they are. The candidates that do well are those who are ready to share themselves fully. The ones who struggle are the guarded and fearful. 

Are we being fair?

One can argue that we are unfair to expect as much transparency as we do. After all, not all employers are safe with personal information. I would counter with this argument. 

We are hiring therapists, not bus drivers. A key aspect of therapeutic success is who the therapist is, often referred to as the “person of the therapist.” (BTW, Harry Aponte has co-authored a book called “The person of the therapist training model.” Well worth the read.) We have one hour to discern who the therapist is. A direct and somewhat challenging interview is the best way to get a sense of who the therapist is.

The other significant part of our interviews

Thus far, I have only talked about what we are asking of the candidate. In truth, this is a “match-making exercise.” The candidate is evaluating who we are as well. Therefore, excellent job interviews also include a bit of a marketing agenda.

Because of the dual agenda going in a job interview, I believe that even if I were a solo practitioner, I would still want a two-interview process. I might organize the interviews a bit differently but I still would want two looks. One might focus more on what the candidate is sharing and the second, answering questions and then more on my vision and hopes for the candidate and practice.

In our case, we had some materials on our website just for candidates for employment. And I would argue that our whole website and the branding that it demonstrates is part of our marketing to candidates. (Read here on how to utilize all parts of your organization in support of your branding message.)

Beyond what candidates can discover publically, we spend a significant amount of the first interview sharing who we are and how we do things. We go over things like:

• Who the owner is and how supervision is structured
• Our meeting schedules; See How we used regular meetings for building our culture.
• The three areas we want our clinicians to focus on: 
  • Do good clinical work
  • Connecting in our communities via our Community Connection Plans program 
  • Contributing to what we call “our mentoring culture”
• We also talk about Our Philosophy of Working in a Community, a guide we use with our leaders and staff.

The second interview

After the first interview, we send an email with several other documents which are not shared publicly:

• An Overview of who we are that includes a list of staff, support staff, and some information about our three locations.
• A document that explains how our therapists get paid
• Material that helps them make a rough estimate of how quickly they will build a caseload and the income that comes with that
• The “Top Ten Reasons” to join us

All this information then gives the candidate what they need to ask questions in the second interview. How they ask questions, then also gets into the mix. And if I were a solo practitioner, I still would send out some info after the first interview to prime the pump for the second.

If after the two interviews we were still interested in the prospect, we send a contract clarifying the position we are offering, who their supervisor will be, how to ask any further questions, and then how to let us know if they want to join us. 

The mistake of ignoring real issues 

Our goal is to use the interview process to collect as much real-world information as efficiently as possible. After we have completed our interviews, we create some time in our regular leadership meeting to discuss each candidate. 

Our goal is consensus about each candidate, but that did not always happen. When it did not, we would slow down to the pace of our conversation to fully understand why the differences arose. Sometimes that discussion would settle things.

Our biggest hiring mistakes occurred when our discussion minimized one of our leaders’ objections. Rarely was an issue entirely missed by all interviewers. More typically, we saw an issue but minimized the difficulties that would emerge. Big mistake.

The mistake of overreacting to an issue

No doubt, we made the opposite error as well, i.e., we took an issue too seriously. There are two aspects of the interview process that tend to make us risk-averse. First, many excellent candidates struggle to represent themselves well in the interview process. No doubt, we have made errors in turning down candidates whose ability to share their insights was compromised by their anxiety.

Second, our leadership team comes to the process with our prejudices born out of past employee difficulties. How could we not be influenced by the bruises from our history? 

So in the end, we have to be at peace with the knowledge that we have passed on some excellent candidates. And we need to at peace that we will hire people we should probably not have hired. I am okay with that.

After the excellent job interview

On the one hand, I think a rigorous process that requires the candidate to be able to trust the leadership with their personal history seems right to me. And I believe our approach starts the relationship going in the right direction. My goal is that the process itself says that we expect candidates to bring the “real you” to work, and you will experience the “real me” in return.

And on the other hand, I think that no matter how excellent our job interviews and our team, we will make hiring mistakes. That seems fine with me as well. We will try to mitigate the damage by three methods that I discuss elsewhere:

• training our staff in how we want them to do things
• the supervising of staff both administratively and clinically
• and if all else fails, move toward firing those that are damaging to us (For more on these employees, read here.)