Perry: In this episode of The Therapist Experience, I’m speaking with Traci Lowenthal from Creative Insights Counseling. This is The Therapist Experience episode number 20. Welcome to The Therapist Experience. The podcast where we interview successful therapists about what it’s really like growing a private practice. I’m Perry Rosenbloom, the founder of Brighter Vision, and I’m just so excited to introduce our guest today Traci Lowenthal from Creative Insights Counseling. Traci, are you prepared to share your therapist experience?

Traci: I am, thank you so much for having me today, Perry.

Perry: Thank you so much for being on this show, Tracy. I am so excited for our interview. Let me hop in and tell the audience about you here.

Traci: Okay.

Perry: So Traci Lowenthal began her training at the Aid Service Center in Pasadena in 2003, while completing her doctorate in clinical community psychology at the University of La Verne. Dr. Lowenthal’s clinical experience includes the following groups. Persons identifying as LGBTQIA, those living with HIV and AIDS, caregivers of cancer patients, college students, older adults, and survivors of sexual trauma. Upon licensure Dr. Lowenthal opened her private practice in her hometown of Redlands, California and maintains a second location in Claremont, California. Her practice specializes in working with persons identifying as LGBTQIA, she is committed and passionate about providing quality mental health care to this richly diverse group. Dr. Lowenthal is a long-time advocate of equality for this community and brings tireless commitment to her work as a clinician and educator. In 2014 Dr. Lowenthal developed Creative Insights Counseling as a way to work with interns and provide supervision to those looking to work in a private practice setting. Together with her staff Dr. Lowenthal now provides training and outreach in many different settings and her writing has been featured in a variety of publications. Traci, I gave a little overview of you there but why don’t you take a minute, fill in the gaps from that introduction and tell our audience a little bit more about you personally and about your practice?

Traci: Okay, great. I actually have a really great introduction there so I’m trying to imagine what I can add to that, but I think that some of the most important pieces for people to know in terms of my growth and private practice and all is that, one of the most important things, it’s not part of my introduction there, is that I’m a parent and that being a stay-at-home mom was something I wanted to do in addition to starting a private practice. So I’ve kind of combined those two things over the years and tried to find that balance. I know probably a lot of your listeners are interested in that and have experienced that, so I like to throw that out there as something that’s really important. And I think that my specialization is really important too. So for folks looking to branch out in private practice or to expand their current practice, that having a specialization or a niche is a really important piece too.

Perry: I couldn’t agree more. You know, that’s a common theme that we hear with almost all the therapists that we interview here is that they have found a niche that they have really been able to specialize in working with a specific group or specific audience, and really specialize in that. And that helps them with their marketing, helps them be a better therapist overall and really helps grow their private practice. So how is it that you came to start working with the LGBTQIA community and really focus on that niche?

Traci: Actually, my intention wasn’t necessarily that. My intention was to work with folks living with HIV and in that environment I also had an opportunity to work with a lot of gay and lesbian folks, and then my second client ever was a transgender woman, and I had no experience working with anyone identifying in that way. And people that I was working with and the clinic I was providing care in, didn’t have much experience either. So there was a ton of learning and I really, really valued that learning. But also recognized almost immediately that this was an incredibly under-served population. So because of that first client experience it really kind of propelled me into doing more of that work.

Perry: And what was it like, your second client ever to be a transgender and, correct me if I’m wrong, not really being prepared to work with that community? How did you navigate that in order to provide a high quality level of care and service?

Traci: Right, right. I think that’s a very accurate statement. I probably wasn’t really prepared to work with her if I’m being honest. And luckily I had an amazing supervisor and also we always want to remember that clients, it’s not their job to educate us, especially with regards to their gender identity or sexual orientation, or lots of different parts of their identity. It’s not their role. And yet, in this situation there was really nothing else available to this client. So I think she helped me understand a lot about her specific world and her specific world and her specific experience. And my supervisor, and other people within the agency, we were continually trying to find more information and trying to build my knowledge base and do the very best that we could. And I got to work with this client for, I think about two years. So a lot of growth and– It wasn’t ideal that I learned that I had to get so much education from her but it definitely allowed me to have a place to start.

Perry: It sounds like the agency you were working with was incredibly supportive and so was your supervisor in helping you explore that, is that accurate?

Traci: Absolutely, absolutely. I really think that if I started somewhere else my path might not have been as awesome as it has turned out to be. So I’m really, really grateful for them.

Perry: Isn’t it just so amazing how that can happen? These small little decisions we make in life adding up to such bigger life-turning events and really helping define who we are as an individual. I always find that such a fascinating thing to look at.

Traci: Yeah, me too. I mean really, one decision like which college you go to or which practicum setting you accept, those things really kind of set you on your path or put you on your direction. And I really do think that’s amazing too.

Perry: So Traci, how long ago was it that you started working with this client?

Traci: This was in 2003, so this was my first practicum setting.

Perry: Got you. Traci, you’ve come such a long way from there. That’s solid 13 years. And that journey, we love exploring the journey and experience of every therapist we speak with, and especially their entrepreneurial journey. So if you wouldn’t mind, can we go back to a point in your career as a therapist where you were just as low as you could possibly be in your journey and you were just ready to throw the towel, and then more importantly, can you share with our audience how you overcame that struggle and persevered through?

Traci: Sure. It’s interesting to think about it from that perspective. I don’t know that there was a time that I identified as being the lowest point or anything like that but I think when a couple of times come to mind when I very newly opened my private practice. The time that I got licensed, when I got– Because private practice is a little scary, right? If you’re not starting with a clinic or you’re not starting in an established practice, I literally passed the exam, found an office to sub-lease, sent an announcement to my newspaper, and I waited. And that was a scary place, like I’m going to sit here, how long am I going to sit here and wait?

Perry: What was the first thing you did after you decided to stop waiting? Do you remember?

Traci: I think I probably placed my ad on Psychology Today and then I contacted the local university and asked them what it would take for me to get on their referral list.

Perry: And do you remember what it would take for you to do that?

Traci: They invited me to lunch.

Perry: Fantastic. That’s great.

Traci: Yeah, I went to lunch and I got some clients pretty quickly after that and I also was asked to teach a class at the university because of that lunch.

Perry: And because you decided not to wait and you picked up the phone and you made that call, and you made that connection.

Traci: Exactly, exactly. I just saw it, well, I’m going to call who might be able to help me.

Perry: So that was a local university in Redwoods, is that correct?

Traci: Redlands it’s the University of Redlands.

Perry: Got you. And did you reach out to the director? Who did you reach out to? How did that go down? Can you share that story with us?

Traci: Yeah, I just called the– I looked up on– I don’t even think it was the internet at that point. I think I looked in the phone book or something and I looked up the university counseling center and I called the front desk and I asked who the director was, and they told me, and I said, can I talk to her? And I think I left her a voice mail and she called me back. And she said, well, we would like to meet you in person before we add you to our referral list. So I kind of thought, ah, oh God, I have to go and meet them. And I did and it worked out fine.

Perry: Was that your first significant referral source for your private practice?

Traci: Yes. That one and the University of La Verne where I had gone to school. I was also on their referral list.

Perry: And do you find that universities are still a significant referral source for you?

Traci: Yes, very much so. Our second location in Claremont is literally steps away from the Claremont colleges and there are several undergraduate schools there, and graduate schools. So they are various things that become a part of our referral at this point.

Perry: And I would imagine you chose that location very specifically then?

Traci: Yes, I did. Actually, something I tell people that are still in grad school, I suggest that if you are able to think about where you want your private practice to be, if that’s something that you want to do, start thinking about where you want to live, where you want your private practice to be. And choose your internships based on those desires. I knew I needed to stay local because I have a family and so I only applied– This is crazy, I wouldn’t recommend this. I only applied to one pre-doc, and I got it.

Perry: Wow, congratulations.

Traci: Thank you. But I did that very strategically. My goal– And that was the counseling center of services that Claremont College is. So I knew that if I could get my internship there that I could create these relationships with referral sources, and then I would be able to open an office nearby.

Perry: And with all the therapists I’ve spoken with and doing the Therapist Experience, I’ve never heard someone say that they have networked with universities and directors of counseling centers there to get on the referral list. And making that a signif– I have not. It’s a great strategy. It might have been mentioned off-hand but I think you have a lot of great value to be offering here and log great experience with it that nobody else has mentioned it yet.

Traci: Yeah, and I would recommend to anyone that’s listening, that’s looking to start a private practice, to do that, because now more than ever college counseling centers are overwhelmed, clients are coming in with more and more significant mental health issues. More and more clients are coming in having already been prescribed psychotropic medications. And the counseling center of University of Redlands and the one at the Claremont College is monsour counseling, we’re overwhelmed this year. So that is unfortunate but it also provided a great opportunity for myself and other therapists that are in those local areas to provide support to those students.

Perry: Do you think that because of your niche that makes it so that college counseling center would be a better referral source for you than perhaps other niches?

Traci: Not necessarily, I mean, I think that’s definitely a component of it. And that is because there’s not as many folks that have this specialty, at least in the Inland Empire where I am. But I think that college counseling centers are a great referral source. Because if you think about it, a college counseling center is very much like a private practice, you have people from all walks of life, all socio-economic places, all cultural backgrounds, all sexual orientations. So in that way there’s a real diversity in the students that are presenting for care. So if your specialty is anxiety, if your specialty is eating, if your specialty is people of color, there’s all those different identities can be found within a college counseling center.

Perry: Most certainly. So you have the one major university, then there’s a few colleges near your Claremont office, is that correct?

Traci: Yes.

Perry: Are there any other community colleges that you’ve gone to? Are there counseling centers there or is it mostly just small private or state colleges or universities that have those centers available?

Traci: Yeah, I think private colleges for the most part have college counseling centers. I know I’m also near Cal State San Bernardino, they have a counseling center. And I can’t remember if I’m specifically on their referral list or not but I have gotten students from there as well. I market myself as having a specialty in LGBTQIA work but I also market that I have a lot of experience with college students, and that’s kind of branched out into working with the parents of college students too because they experience a lot of difficulty when their kids go to college.

Perry: I believe, I know my parents did.

Traci: And I could imagine. I have a ten year old and the idea of sending her away to another state is already something I’m thinking about. Like, how are we going to navigate that? So that’s another group of people that’s kind of a branch off of the college students.

Perry: So Tracy, there was just so much great knowledge and information there. I hope people are taking notes about this. But you’ve come such a long way from that first phone call to the counseling center. But something we often see therapists struggle with in the early days is pricing themselves well. Would you mind sharing with our audience what your current rate is to see a client and what your journey was to that rate?

Traci: I will. My current rate is 150 and interestingly enough, I started out at 120 when I– So I opened my private practice, I got licensed in 2009 and I started at 120. And that was at the recommendation of a professor of mine who was in private practice. Interestingly enough, that professor’s rate is still 120 dollars and he’s been in private practice for probably 15 to 20 years. So that was a moment too where I thought, wow, there’s a lot of resistance in mental health to increase our rates or to have a marketable rate. So I started asking around and I think I raised my rate to 150 two years ago. And I realize today in talking with a client that my rate is probably too low right now.

Perry: How did you realize that?

Traci: The client came to me today– Something that my specialty allows me to have an opportunity to do is sometimes to write a letter for someone to have gender confirmation surgery and this woman came to me and was needing a second letter. She said that she shopped around and that I was the most reasonable in pricing. And I said, oh would you mind sharing with me what other people were charging you? She said, 200 dollars. And I thought, wow, okay, that’s important for me to know. So my plan had been to raise my rates to 165 starting in the fall and so I’m kind of evaluating whether or not that’s going to be the way I go to or if I need to go a little bit higher. It’s a tough being for me too because a lot of people who identify as transgender also experience poverty and so I have to be mindful of the people that I work with and how to provide services in a way that is fiscally responsible to myself and to my family and to my practice, but is also going to continue to be a support to the community in which I serve.

Perry: That was actually going to be my next question, or related to that. So how do you feel about that? Are you going to provide a sliding scale or you’re going to try to find other ways to give back to the community? Elaborate on that for our audience a little bit, if you don’t mind?

Traci: Yeah, absolutely. I’ll probably do a combination of that. I’ll probably continue to offer sliding scale and we do that now. And we probably have too many sliding scales if I’m honest. Because it’s really difficult when someone calls and they’re already going to drive an hour and a half to see me and get what they need, and not to be able to provide them with a referral, sometimes I just say, okay, well, I’ll make this work. And I have probably done that more often than I should to be fiscally responsible. But I do try to offer trainings. I do try to get out into the community and provide services, and put myself out there as a resource to the community. So I do that, I give lectures in classes, I’ll do whatever I can, honestly, to support the community. But also it’s difficult as a private practice owner to maintain that balance. And that’s something I’m always evaluating.

Perry: You mentioned giving teaching and when you first mentioned that you reached out to the director, that, I forgot if it was a she or he, had mentioned that they would love for you to teach. Is that something that you still do regularly?

Traci: Yeah, I do. I taught at the University of La Verne, I taught at a local junior college or community college, I should say. And I’ve taught several classes at the University of Redlands and really cool experience just happened to me where I normally teach a class at the University of Redlands during the month of May. And because of a family obligation I wasn’t able to do it this year. So I was able to give my intern Paddy that opportunity. So she got to go and teach a class. It was really, really cool to be able to share that with her because that was one of her dreams, to be able to teach a class. So my inability to fill that spot became an opportunity for her.

Perry: That’s fantastic.

Traci: Yeah, I know. It’s really cool.

Perry: So you enjoy teaching. You have a pretty full schedule it seems. Tracy, is it just you at your practice or is it a group practice as well at this point?

Traci: It’s just myself and my intern right now although Paddy is really, really close to licensure. So we’ve been talking lately about what that would look like once she gets license that we want to take on licensed person or if I want to take on another intern. We’re definitely kind of at the edge of that, trying to figure out what our next step is for growth. Because we’re growing pretty exponentially at this point and trying to figure out how to manage that in a way that is useful for everyone.

Perry: Certainly, and that’s a really tough thing to grapple with.

Traci: It really is, it really is. I took on my current lease for five years and it’s just a single office. It’s a large office but a single office, and I thought, well, by the end of this lease I’ll need multiple offices. And we’re already there and I’m only a year into that lease. So we’ve been sub-leasing from someone else in the building. You know, trying to cobble together everything that we need to do to continue growing.

Perry: So how do you feel about that? Do you want to take on a fully licensed therapist in your office or do you want to continue doing internships?

Traci: You know, I don’t know. I can see us doing both honestly. I think a licensed person would be fantastic but I also really enjoy the process of watching interns grow and helping them kind of figure out what they want in their private practice journey.

Perry: Or you could try both? Hahahaha.

Traci: Yeah, I think I might.

Perry: That’s a great problem to have. It’s a fun journey, that’s part of the joy of being an entrepreneur. You get to experience that journey and figure out how to navigate those waters because there’s never a clear answer and there’s never a perfectly right answer. It’s figuring out what’s best for you and best for your business and the people who work there. So I have a feeling I know the answer to this question. I’m going to go ahead and ask it anyways. Over the years we find that therapists typically struggle with marketing their business. As you and I both know, there’s no way that you can grow a thriving private practice without marketing. What was the single best marketing move that you made for your private practice and why do you feel like it worked so well? And actually let me add an indent into it. If it is picking up the phone and calling that clinical director, how about the second best marketing move you made?

Traci: So you are correct. That is the thing that I would say was the most valuable. And even before that, something I mentioned earlier, I think knowing ahead of time where I wanted to practice and moving toward that before I’ve even graduated was probably one of the most important moves I’ve made with knowing before I graduated that I was already creating relationships with people that would be able to help me grow a private practice and allow me to help them. That was a really important move and I just kind of did that. I just kind of thought, well, I want to work in Claremont. I know I do. So I want to be as close to that location as I can. So that actually ended up being a really, really good thing.

Perry: So one more question along these lines, Tracy, you went to school to become a therapist. Not to get your MBA.

Traci: Hahahaha. Correct.

Perry: But, you know, being an entrepreneur you’re basically getting an MBA whether you like it or not. So what’s the one thing–? You knew right away you wanted to go into private practice, that was your path. What’s the one thing you wish they would have taught you in school about starting your own business that they did not?

Traci: Oh my gosh. It’s not one thing, it’s like 4000 things.

Perry: Well, let’s talk about it.

Traci: I wish they had offered– And I’ve since talked to my grad school and offered to kind of do this myself. I wish they had at least offered a workshop on how to start a private practice. Whether a workshop or a class, or a seminar that was a couple nights, just an opportunity to explain to people what it looks like to take insurance or not take insurance. How do you find the place to have your office, what does that look like? What’s the financial investment of getting furniture? Just the nuts and bolts of opening an office. Things like business liability insurance. These are all things that I’ve kind of had to figure out as I go and you do that by talking with other people, but if there’s someone that can come in to grad school classes and offer that, or even post-grad stuff. Just come in and talk about the very basic nuts and bolts things that are required to start a private practice. I think that would be really, really helpful.

Perry: Gosh. Thankfully there’s lots of good resources online now that can help you with that but you think– Especially in California where it seems that most people go into private practice, you’d think that they would just prepare you for that, just a little bit with just Business 101, what you need to know if you want to start a private practice.

Traci: Exactly, exactly.

Perry: So to learn those nuts and bolts, obviously there’s trial by fire. Haha. Which we all had to go through at one point or another. Are there any resources out there that you would recommend to our listeners who might be in that situation?

Traci: You know, you mentioned something that’s really, really important. I think honestly Facebook has been an amazing opportunity to learn for me and I think for a lot of other practitioners. There are so many groups that are geared toward therapists in private practice, or private practice mental health providers. So those are great resources to be able to go in and post a question or to see other things that people have asked about. So I feel like Facebook is a wonderful opportunity. I know that some organizations offer business bootcamp kinds of classes and I think those can be great. Also coaches that aren’t therapists themselves are really wonderful resources for finding the answer to those nuts and bolts questions. It’s always great to have a person that you can ask anything of. And I think sometimes we’re embarrassed to ask things online to a degree like, oh I don’t want to admit that I don’t know this but I think if you can have a business coach that’s also a mental health provider, that can be really, really valuable.

Perry: Any specific Facebook groups that you really love and value the community of?

Traci: Yeah, definitely. There is one called ‘A Therapist in Private Practice’ and that’s I think got about 3000 members, that one’s really great. I actually started a Facebook group for therapists who want to work with the LGBTQIA community and that one is called ‘LGBQIA and Trans Affirming Therapists’. So that’s a great place to ask not only private practice questions for some folks but also to get resources if that’s the kind of work that you’re doing. I’m part of a group called blissful practice. I don’t know if that’s an open group or a closed group. But yeah, I think if you search private practice or also mental health in Facebook you’re going to get a lot of different options. I honestly can’t remember all the Facebook groups I belong to because there’s so many of them.

Perry: Well, we’ll be sure to link those three in this week’s show notes for all of our listeners which, everyone, you’ll be able to find over at Brightervision.com/session20/ Alright, Tracy. Now we’re going to move onto the final part of the interview. The part we like to refer to as Brighter Insights. And I just really love this part because what we get to do is distill down your advice into quick little sound bites that our audience and listeners can use to motivate and inspire them throughout their week. So are you ready?

Traci: I think so.

Perry: I know you’re ready. Tracy, what or whom inspired you to become a mental health professional?

Traci: Let’s see. I had a wonderful therapist when I was in my 20s and that really opened my eyes to the possibility of doing this with and for other people. I also had an amazing professor in grad school. His name is John Pelitery and he was excited about psychology and actually he was also a professor of mine in under-grad so I got really excited about psychology through being in his classes. That was very motivating to me.

Perry: What is it that you do to clear your head and get a fresh start in your day?

Traci: Hmm, go outside.

Perry: Haha. And living in California you better love going outside, right?

Traci: Yes, yes. Going outside and just kind of looking up at the sky and remembering that whatever it is I’m getting tense about or worked about is probably not as big a deal as I let it become.

Perry: This too shall pass.

Traci: Yes, exactly.

Perry: What are some tools that you’ve used to leverage the power of technology in your private practice so that technology is no longer a hurdle but instead an asset for you?

Traci: I highly recommend having an electronic health record provider. I use Therapy Notes. I know that there are several out there, Therapy Notes is just the one that I happen to start with. And the idea of being paperless was so frightening to me but it is so liberating. I highly recommend doing that.

Perry: I also notice that you use vCita.

Traci: Yes, I do.

Perry: Tell us about that. Do you like it?

Traci: I love it. It is wonderful because I am able to collect payments from clients and it’s hipaa compliant. People can contact me to schedule appointments. I can have confidential communication with clients that is safer and more compliant than just a regular email. And it’s a really great way to stay in touch with my clients. I was resistant to do it at first because again, I was a little intimated by another platform. But it’s worked really well and it was really so simple to have Brighter Vision add it to my site and it just worked out really well.

Perry: And are you on– I know they offer different plans, are you on their free plan or are you on a paid account?

Traci: I’m on the paid account.

Perry: Got you. Generally speaking that’s a better way to go with most things. You’ll get a lot more value of a product and it will be a lot more useful for you, I think.

Traci: Yeah, I agree. And you know, everything feels a little scary when you’re spending money on it but it has brought so much ease into communicating and invoicing with my clients that it’s totally worth it.

Perry: And that’s what it’s about. That’s the power of technology, right? You get to leverage technology to make your life easier. And there’s learning curves, I’m sure there was a learning curve. In other practice management tools there’s a learning curve. Once you get past that learning curve, man it’s going to make your life easier.

Traci: Oh yeah. It’s so much simpler than trying to manually do things so I definitely recommend both of those things.

Perry: Tracy, what’s a quote that you hold near and dear, something that has helped formulate your perspective on life or has motivated and inspired you?

Traci: I have two quotes that I like to share with people. The first one is from Yoda, believe it or not, “Do or do not, there is not try.”

Perry: Oh yes. The first Star Wars quote on the Therapist Experience. I think that’s going to make a lot of people in our office here really happy.

Traci: Yay. I know that Star Wars is so big these days, right? And then also a quote that I gave one of my first clients on a little paper weight when we terminated which was, “What would you attempt to do if you knew you would not fail?”

Perry: Do you know where that was from?

Traci: I don’t remember off the top of my head. It’s been attributed to a couple people. I want to say Thurrow but I could be wrong about that.

Perry: Both of those are great quotes though.

Traci: Yeah, and when I remind myself of them it’s really motivating.

Perry: If you could recommend one book to our audience what would that book be?

Traci: The Gift of Therapy by Irvin Yalom.

Perry: Alright Tracy, last question. If you moved to a new city tomorrow, you didn’t know anybody and all that you had with you was your computer and 100 dollars to start a new private practice what is it that you would do on your very first day?

Traci: I would create a list of therapists in the area and I would reach out to them and ask them if I could contact them, have lunch with them, get on the referral list, something like that. I would make personal contact with some people.

Perry: Perfect. Tracy, this has been a great episode. You’ve provided so much value and so much great advice. Do you have any parting words for our audience?

Traci: I think I would love to just encourage people that private practice is possible. You can be cash based and you can really create a professional life that you look forward to participating in every day.

Perry: And isn’t that just wonderful? I mean, that’s what we’re all looking for, that’s what we’re all strapping towards as entrepreneurs?

Traci: Exactly.

Perry: Fantastic, Tracy. Well, where can our listeners find you to connect and learn more about you?

Traci: Our website is Creativeinsightscounseling.com/ and we also have a Facebook page. Those are probably the best ways to get in touch with us.

Perry: Perfect. And of course we will have all those links and other great resources that Tracy has mentioned at this week’s show notes at Brightervision.com/session20/ Tracy, thank you so much for being so generous with your time, your expertise, and your knowledge.

Traci: Thank you so much, Perry. This has been great.

Perry: Thank you so much for tuning in today. If you have a question for us you can email it to us at [email protected], and of course, if you’re interested in launching a website reach out to us. Brighter Vision is the worldwide leader in custom therapist website design. For just 59 dollars a month we’ll build you a website that is as unique as your practice, provide you with unlimited tech support, and complementary SEO so people can find you online. That does it for today. Thanks again for listening and we will see you next week.