Principles driving the growth of my mental health practice

Many principles drove the growth of my mental health practice. At my retirement in 2019, the practice had over forty clinicians and ten support staff working in three locations, and it continues to grow beyond that transition.

Here are my reflections on why it happened.

I re-made myself into what the business needed
My main principles
So what are the principles driving the growth of my mental health practice?

I re-made myself into what the business needed

Certainly, the biggest reason for any organization’s growth is its leadership. Early on, I learned to be guided by what the business needed rather than what I felt like doing. I have written extensively about these decisions. For example, see:

As the company required me to reorder my priorities, I made those changes. The transformation was a crucial factor in the growth of my mental health practice.

I started as a clinician who owned a business. I became a businessman who was a clinician.

But let me be more specific in the ways that I changed.

1. I battled my internal fears as they arose

Leading my organization brought up many fears. I have written several posts about those fears:

My biggest internal fear was that becoming the boss, the MAN, would mean I would lose touch with what it is like to be in the trenches. Of course, as the owner, my job was to superintend everything to ensure the system worked for all constituents of the practice–clients, staff, referrers, and owners. And yes, that meant that, at times, my decisions did not please all. But I discovered I could balance most competing constituents’ needs and keep most happy enough that they continued to stay connected to us.

2. I learned to love the new demands

As I have mentioned, every business makes demands on the owners. I’ll mention two I came to love – fixing infrastructure issues and leading staff.

No matter our organization’s size, there were always things that either broke or needed improvement. This process of identifying the issue and then finding the resources to address the problems became fun. Why? Because typically, fixing something meant digging into areas where I had no training–technology, software, accounting, legal issues, marketing, etc. Consequently, I had to locate help from those with that expertise. I enjoyed the learning and the collaboration. Furthermore, solving the issues was very satisfying.

When I began to practice, I did not know I would enjoy leading a group of people who came together to deliver quality mental health services. It never occurred to me as a possibility until I was in the middle of doing it. But as I experienced the growth of my mental health practice, I discovered that I enjoyed working with a team on all the parts of what it meant to do a good job. I found joy in creating new ways to do things and then finding ways to maintain the systems we constructed. Moreover, the focus on teamwork contributed to the practice growing beyond what I could have envisioned.

3. I faced uncomfortable decisions head-on

As the years went on, I got quicker and bolder in making corrections. Improving my decision-making was necessary because it became clear that there are no avoiding mistakes. Therefore, the best remedy is to be quick to correct things as we become aware of the error. My goal was to take my time evaluating remedies and options but then move quickly and confidently once I selected a direction.

I have written about some of these corrections in these posts:

4. I worked on trusting others and letting go

One cannot grow an organization by oneself. Therefore, every leaders must learn to delegate even when we know that doing so will lead to more mistakes initially. I had to learn to allow them to make mistakes, and have faith that they would learn from them. That is the only way to make continuous progress. To grow, we must let staff learn and improve.

A second trust principle that contributed to the growth of my mental health practice was my commitment to believing the best about others until proven unwise. This commitment to trusting others is not the case in some organizations. I learned that I must actively fight off the temptation of paranoia. To lose this battle against paranoia is to allow mistrust to infect the whole culture.

My main principles

1. I tried to match employee skill-set with the needs of the business

One of the fundamental principles driving the growth of my practice was the ability to assess and then utilize the strengths of each of our employees. While this was especially true when assigning tasks to our support staff, it applied to our clinicians too. Everyone employee thrives when they are working out of their sweet spots. Finding what those are and helping the team function there benefited everyone.

2. I tried to focus on improving our systems and processes

One way to define the formation of a business is as the creation of a systematic set of processes for getting every essential thing done. Therefore, one of my primary duties as an owner is to superintend that system of doing things in order to find what needs improving and apply the required resources to improve the system. We don’t need perfect performance, but we need sufficient performance that our systems keep things running smoothly.

3. I focused on creating quality experiences and not making money

I have written so much about money on this website that one might think pursuing profit was a central aspect of growing my mental health practice. It was not. My main focus was on our mission.

We defined our mission in three ways. A commitment to:

Do good clinical work with our clients
Get out of one’s office, and connect with the community (i.e., marketing)
Be good teammates where everyone invests in our mentoring community

These statements were more than window dressing and influenced our recruitment interviews, training, supervision, staff meetings, and many aspects of our work.

Meanwhile, while pursuing that mission, my goal as the owner was to make the finances work well enough to facilitate those ends. In other words, the place of finances is as a means to achieving the mission and not the end itself. The story of my practice has born out my faith in this focus. The organization made money when we did the right things to accomplish the mission.

I have expressed these ideas in other ways in these posts:

4. I did not fight the system but moved in rhythm with it

There is no question that the American mental health system itself has many limitations and flaws. Consumers’ experience is not the system’s primary focus; ensuring profit for some entities is the main concern. For instance, insurance companies, physicians-centric treatment, and hospitals are the primary beneficiaries of how the system functions today. I have talked about this in these posts:

Because the margins in my organization were small, which is typical for most mental health practices, I did not have much energy for the fight to change the system. I was looking for a way to survive in the existing climate.

Some owners opt out of the insurance gig and take only out-of-pocket clients. While this solves some issues, it does not change the system itself. I made a different choice, i.e., to work in the insurance-based system and do the best we could. Part of my reasoning was that I did not feel right asking my clients to pay for something when they had an insurance benefit that would pay for the service, albeit at a lower rate for the clinician. I chose to provide clients with an excellent clinical experience within their insurance policy limits, even as that decision cut into the clinician and practice profits.

To sum up, I chose to stay a part of the system and live with the consequences of that decision.

See this post for more on this subject:

Why join insurance panels

5. I focused on continuous improvement of everything

As the one in charge of the growth of my mental health practice, I was constantly scanning for ways to improve the ways we did everything. As a result, we were continually developing projects and initiatives to improve our processes, systems, technology, and training. I have written about some of these transitions and projects in these posts:

So what are the principles driving the growth of my mental health practice?

First, I needed to work on myself. That project included:

Battling my internal fear
Learning to love the new demands
Facing uncomfortable decisions
Working on trusting others

Furthermore, I focused on:

Matching employees with the tasks required for the business to thrive
Improving our systems and processes
Creating quality experiences and not over-focusing on money
Staying in rhythm with the mental health system and not fighting it\
The continuous improvement of everything we did

Put all these principles that drove the growth of my mental health practice, and you will see growth too. Guaranteed.