wp 70 | The People in Your Practice: Understanding the Role of a Clinical Director with Julie Roberts

Written By James Marland

Introduction:

As therapists who run private practices, we understand the importance of having a well-functioning and efficient team to provide quality care to our clients. One vital role in ensuring the smooth operation of a practice is that of a clinical director. Today, we will explore the responsibilities and significance of a clinical director in a private practice setting based on a conversation between Whitney Owens and Julie Roberts, a clinical director at Water's Edge Counseling.

The Role of a Clinical Director:

A clinical director plays a pivotal role in overseeing the clinical operations of a private practice. They take on a wide range of responsibilities, including policy development, staff supervision and training, risk management, quality improvement, and maintaining ethical and legal compliance.

Policy Development: 

One important aspect of a clinical director's role is policy development. Julie Roberts, in her conversation with Whitney, mentions the significance of creating and implementing policies that provide structure and clarity to the practice. Policies on topics such as paid time off (PTO) and documentation standards ensure that everyone in the practice is aware of the expectations and guidelines.

Staff Supervision and Training:

Clinical directors provide supervision and guidance to clinicians in the practice. Julie emphasizes the importance of regular clinical supervision to support therapists professionally and personally, improve their skills, and prevent burnout. This role extends to overseeing internship programs, providing support to associate-level practitioners, and facilitating external clinical supervision groups for social workers seeking independent licensure.

Risk Management and Quality Improvement:

A clinical director is responsible for ensuring proper risk management and quality improvement within the practice. This includes standardizing documentation practices, conducting chart reviews to assess compliance, and addressing any areas for improvement. Julie describes the importance of clear and timely documentation, appropriate use of language, and consistent abbreviation usage to ensure quality care and effective communication within the practice.

Ethical and Legal Compliance:

Maintaining ethical and legal compliance is of utmost importance in any private practice. As the HIPAA compliance officer for her practice, Julie emphasizes the need to stay up-to-date with HIPAA regulations, document training, and ensure proper handling of records. She also highlights the ethical considerations when working with clients and the importance of objective and non-judgmental documentation.

Collaboration with Practice Owners:

The role of a clinical director involves close collaboration with the practice owner(s). While the owner may have clinical expertise, partnering with a clinical director provides an objective perspective and helps maintain a healthy separation between clinical supervision and administrative tasks. As Whitney and Julie discuss, this partnership allows for a more comprehensive approach to managing the practice, combining clinical expertise with a focus on business and compliance.

Conclusion:

In summary, the role of a clinical director in private practice is crucial for maintaining efficient clinical operations and ensuring the provision of quality care. The clinical director takes on various responsibilities, including policy development, staff supervision and training, risk management, and ethical and legal compliance. Their expertise and guidance enable therapists to provide the highest level of care to clients while ensuring the smooth functioning of the practice.


If you are a therapist running a private practice, consider the benefits of having a clinical director. By delegating some of the administrative and supervision responsibilities to a clinical director, you can focus on your clients and overall business goals, confident that the clinical operations are being well-managed.


Remember, having a well-structured and efficient team is essential for the success of any private practice. The role of a clinical director is invaluable in achieving this goal, creating an environment that supports therapists and ultimately benefits the clients we serve.

What is Alma, and How Can It Help You?

  • Alma - Your private practice support system. Alma offers clinicians the opportunity to join their insurance program, providing benefits such as getting credentialed within 45 days and enhanced reimbursement rates with major payers. 

Wise Practice Work Retreat

Links and Resources

Podcast Production and Show Notes by Course Creation Studio.

  • WP 70 | The People in your Practice: Understanding the Role of a Clinical Director with Julie Roberts

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    [00:00:00] Whitney Owens:

    [00:00:04] Whitney Owens: Going in network with insurance can be tough, such as benefits checks, catering to the insurance company's needs rather than your client needs, late payments, and at times making less than you deserve. Filling all the right paperwork is time consuming and tedious, and even when you're done. It could take months to get credentialed and start seeing clients.

    [00:00:23] Whitney Owens: That's why Alma makes it easy and financially rewarding to accept insurance. When you join their insurance program, you can get credentialed within 45 days and access to enhanced reimbursement rates with major payers. They also handle all the paperwork from eligibility checks to claim submissions and guaranteed payment within two weeks of each appointment.

    [00:00:43] Whitney Owens: Once you've joined Alma's insurance program, you can see clients in your state of licensure, regardless of where you work from. This is particularly great when you're traveling for amazing conferences or with your family. Learn more about building a thriving private pay practice with Alma at helloalma.

    [00:00:59] Whitney Owens: com slash wise practice. That's hello, a L M a. com slash wise practice.

    Are you looking for an opportunity to connect with faith based practice owners and grow your business? Look no further than the Wise Practice Summit. This October 3rd through the 5th, we will be meeting at the Grand Bohemian Hotel in Charlotte, North Carolina. Yes, it is a Marriott hotel. So you can use those special points.

    We will be having amazing speakers, fantastic sponsors who will all be helping you grow your practice. Now, why am I telling you this here in February? Because I want to make sure that you grab 100 dollars off your ticket. The early bird pricing will end on March 1st. So to grab your ticket to the next wise practice summit, head to Whitney Owens dot com.

    Looking forward to seeing you this October.

    [00:02:15] Whitney Owens: Hello friends. And today on the last practice podcast, I have a very special coworker and friend here, Julie Roberts. Hey,

    [00:02:24] Julie Roberts: Julie. Good morning, Whitney. How are you today?

    [00:02:27] Whitney Owens: I'm good. How are you? Good. Good. Yeah. And, um, So, as many of, you know, we're doing this series on the team players within water's edge counseling, and I couldn't move forward without having Julie on the podcast.

    [00:02:38] Whitney Owens: It really is the clinical director and you're going to learn all things about her background and kind of the work she does and how she works with the therapist here at the practice. So, Julie, why don't you 1st, introduce yourself like your background? People want to know about your certifications, things like that.

    [00:02:53] Whitney Owens: Sure.

    [00:02:54] Julie Roberts: So I want to start the podcast off with I'm a unicorn in the sense that I have a degree in both clinical counseling, as well as in social work. So that has served me very well because. I can understand both counselors as well as social workers, and I know that my situation is unique. So, I graduated with my counseling degree in 1996 from Bowling Green State University, and that's an Ohio, if any, Midwesterners are listening.

    [00:03:29] Julie Roberts: And then in 1998, I graduated with my master's in social work from the University of Michigan. And so, for the past, I would say 20 years, I've always been committed to student learning, teaching. Lecturing will also concurrently being committed to clinical work because I think it's important as a clinical director that you're able to wear both hats.

    [00:03:57] Julie Roberts: Which would be understanding, you know, the reasons for, you know, compliance or ethics, things like that, but also still practicing physically seeing clients.

    [00:04:12] Whitney Owens: Definitely wonderful. And then why don't you share a little bit about, um, some of your previous jobs and kind of how you made your way to water such

    [00:04:18] Julie Roberts: counseling.

    [00:04:19] Julie Roberts: Okay. So, I worked primarily in medical social work. And 1 of my sub specialties is counseling and therapy for people with serious and chronic illnesses. What I found as a medical social worker is so much of. Medicine focuses on treating a disease. And it leaves out the person, so the complex feelings, or how families coping with the chronic illness.

    [00:04:51] Julie Roberts: So, I actually worked in palliative care as well as hospice. And also, um, oncology or at a cancer center. So then about 2 years ago, I transitioned to private practice because I really wanted to be able to spend more time formally providing excellent clinical services to people living with cancer or other serious illnesses.

    [00:05:18] Julie Roberts: Yeah,

    [00:05:20] Whitney Owens: wonderful. Thank you so much for sharing that. So I think a lot of people I'm going to kind of start asking some of the questions that a lot of practice centers ask me, they're going to want to hear from you about. Yeah. So, the 1st question would be kind of what led you to leave where you were and go to a private

    [00:05:35] Julie Roberts: practice.

    [00:05:37] Julie Roberts: That's a great question. So there's 2 parts to that. The 1st, very obvious example. And I want to be transparent. Um, I was providing crisis intervention services and palliative care during cobit. So, I worked with a palliative care doctor and a nurse practitioner. And there were people dying, several people dying every day.

    [00:06:03] Julie Roberts: And then compounding that loss. Were the families were not able to come in and to be present or to bear witness to their loved one dying. So, I know cobit affected all of us in different ways, but I would say, transparently, I had a lot of moral distress. And it was leading into burnout because as a, as a therapist or as a social worker, you go into this work, wanting to help people.

    [00:06:34] Julie Roberts: And when you feel like there is nothing you can do to make a bad situation better. And it happens day after day after day, or the families that you're trying to support become very angry at you and they're not angry at you because of you, they're angry at the message that you tell them that their loved 1 is dying.

    [00:06:54] Julie Roberts: And by the way, you can't come into the hospital to see them. So COVID was definitely a precipitating factor for me looking at what can I do next. Um, the 2nd part is, you know, just seeing from my own fear, you know, as an oncology social worker, I would become very protective of my, my patients and families.

    [00:07:18] Julie Roberts: So, I would be literally afraid to just send. My patients to any therapist, because not all therapists understand the psychosocial impact of. Cancer, and being able to connect. With my clients to talk about their experience. Which is separate than just focusing on the medical interventions, like chemo and radiation and surgery and reconstruction, but really being there to provide this subspecialty type of counseling that really.

    [00:07:55] Julie Roberts: Doesn't exist.

    [00:08:00] Whitney Owens: Yeah. And so you were looking for a change. Yes. And, uh, I found you on indeed. Right? Uh, yes. Yeah. People are always like, where do you find great therapists? And I'm like, believe it or not. Indeed, you know, like, it's pretty amazing, but, um, yeah, when your application came across and your areas of expertise as long as well as the 2 degrees, um.

    [00:08:24] Whitney Owens: Definitely stood out to me, and I, I personally really enjoy hiring therapists that have done agency work and hospital work because I think that it shows a lot of resiliency. It shows longevity that you're willing to stay at a place. That's difficult to work at in a lot of ways. You're committed to the work that you do and then specifically for your situation, which we'll go into a little bit more as we continue to talk, it showed, um.

    [00:08:52] Whitney Owens: Just your attention to detail ability to understand the laws, the ethics, all those things, which was something I was looking for. And hiring, and so to kind of go back a little bit at the time that Julie was applying, I was, I think I was looking to hire a couple of therapists around that time. I heard somebody else at the same time.

    [00:09:09] Whitney Owens: Yeah. Okay. That's right. So, um, I like to hire in twos. I think you've all heard that before. Um, I think it's really good for the camaraderie of the team. People that you hire, but it also saves time and energy in the training process. Um, now I was needing a clinical director, but did not want to promote that out there to the world because I like the idea of hiring someone and getting to know them.

    [00:09:30] Whitney Owens: Um, there's a level of trust that you really want to have with your clinical director. You're going to work very closely with them compared to everybody else on your team. So I wanted to make sure it was a therapist that I trusted their clinical work. 1st of all, and my ability to communicate with them, feeling comfortable feeling, I could give them responsibilities and that's not very many therapists.

    [00:09:47] Whitney Owens: I mean, my practice is great and I love all the therapists, but I'm just saying that's not everybody can take a job like that. That wasn't to knock out my other service. Okay. So anyway, so that was something I was looking for. Um, so. Julie was an easy hire and I knew I wanted to hire her on the spot because she was so great had so much to offer to the table.

    [00:10:06] Whitney Owens: So she actually started out with a traditional therapist position at the practice. And I guess it was, I don't know, 3 or 4 months in. Maybe we made that transition to clinical director. Yes.

    [00:10:16] Julie Roberts: Okay. And you know, one of the beautiful things about working for an agency or a large hospital, and I'm talking about huge health care systems is you learn the impact of understanding policies, procedures, how data can help to show your case.

    [00:10:39] Julie Roberts: Versus just whining and complaining and saying, we need more therapist data speaks. And I remember being in graduate school in my counseling program, and I would take my evaluation courses and my research courses. And I thought this was ridiculous. This doesn't apply to me. Because I'm going to be talking, you know, to clients and I'm going to do private practice, and it's going to be amazing.

    [00:11:07] Julie Roberts: What I will tell you is working for big healthcare systems really taught me the importance of compliance. Also, you know, learning how to chart. Because Whitney, I don't know how you were taught to chart, but I will say, you know, as a clinical director and also helping with student education for many years, this is 1 of the limitations that I see even seasoned therapists.

    [00:11:33] Julie Roberts: They struggle with how do you document? Well, what do you include in the chart? What don't you include in the chart? So that was another piece that was ingrained into my brain from from working at these large hospitals secondarily at large teaching hospitals. You have a huge ethics component, especially when you're dealing with medical issues.

    [00:11:56] Julie Roberts: Um, ethical issues come up all the time, so I was actually honored that I could be on the ethics team for 5 years at a large hospital in Savannah. So I learned a lot about informed consent and who can consent. Um, and HIPAA, I am 1 of those strange people. I love HIPAA. I like to learn about it. Um, I'm also the HIPAA compliance officer for the practice.

    [00:12:22] Julie Roberts: And did you know that every practice needs to have a HIPAA compliance officer? CMS requires that. I

    [00:12:29] Whitney Owens: did not know that until you told me. I don't

    [00:12:31] Julie Roberts: mean to make anybody anxious, excuse me, but it's absolutely true. If you don't have a HIPAA compliance officer, even if you're a sole provider, make yourself one.

    [00:12:42] Julie Roberts: And what's important is that you take as many educational courses. Um, so that you are up to date on HIPAA and what it means and also the different levels of disclosure and helping your therapist that you work with to understand what do we disclose? How do we respond to court mandated subpoenas? You know, it's important to use consultation before you start to release records.

    [00:13:08] Julie Roberts: Because when a court or when we get a subpoena, it's very unnerving the thought of going to court. Um, but if you sleep on it, and if you get consultation from people in your practice, then you realize I'm not reacting. I have to respond to the subpoena to say, I acknowledge I receive it, but I don't have to give the entire medical record or counseling chart.

    [00:13:34] Julie Roberts: To whoever's asking, you know, and I think that that's a tremendous value that we have a pretty good system in place about how do we release records because that goes into hip hop as well as clinical ethics. Yeah. So let's talk

    [00:13:50] Whitney Owens: about what your job entails. I mean, obviously, you talk a little bit about you see clients, but you do a lot of other things outside of that.

    [00:13:58] Whitney Owens: Can you kind of go into that for everybody?

    [00:14:00] Julie Roberts: Sure. So I work full time and I see anywhere from 15 to 18, um, individual therapy clients and or couples. That's another 1 of my sub specialties of note. I don't see, um, young adults, children, adolescents. I, I usually, I prefer Medicare beneficiaries or older adults because they tend to have more chronic illnesses or more complexity.

    [00:14:28] Julie Roberts: Um, with phase of life issues like retirement or children moving away, things like that. Also the things that I do for the practice is policy writing. So identifying wherever there is a need for structure and policy. That was the first place that I started when I took the position. For example, we had no policy for PTO, paid time off.

    [00:14:57] Julie Roberts: Well,

    [00:14:57] Whitney Owens: we had one, but it stunk.

    [00:15:00] Julie Roberts: Well, I wouldn't say that it stunk. I would say that it wasn't clear and it was very vague. Yes, it was. And there's nothing that makes clinicians more angry when they don't get their PTO. And there are times that as a leader, so as a practice owner or as a clinical director, you have to say, we can't have too many therapists off because then it hurts client care as well as revenue to the practice.

    [00:15:26] Julie Roberts: So by outlining, we are only able to have two clinicians off on PTO at a time, you know, the standards and the rules are clearly outlined. So that way, all of the therapists, all the staff understand that we will not allow any more than 2 people off at a time. Yes, there are emergencies, you know, if there's a death in the family that someone needs time off.

    [00:15:53] Julie Roberts: But by integrating structure, being clear to the clinicians, if you have to call in sick, this is what you do. This is who you call. This is the process. Um, also using, um, existing, um, enterprise platforms that we have, such as Gusto. Gusto has been really great in helping to manage, um, vacation and PTO requests, which has been a godsend to our administration team.

    [00:16:25] Julie Roberts: Other things that I do, uh, would be making sure that all of our staff are trained and they have their compliance, um, updated for telehealth as well as, um, risk assessments or self harm and suicide assessments and HIPAA. I make sure that every year we have a complex HIPAA training. And it's important that you not only do the HIPAA training and it can be having your staff Just watch a CEO video for an hour, but what's most critical is in every staff person's, um, staff or their personnel folder.

    [00:17:07] Julie Roberts: You need to really keep track and say, we did have a training on this date and this is for how long because you can give continuing education all day long. But if you don't document it. And if you get a HIPAA complaint, or if CMS comes to audit you, you want to make sure your docs are in a row and that you just take the few minutes to document.

    [00:17:30] Julie Roberts: Yes, you know, my staff took the hip training on this date.

    [00:17:36] Whitney Owens: Definitely. Yes. A big part of your position has been a lot of these policies, procedures, and some of them more office management type things, like scheduling things, PTO things. And some of it has been a lot more on the. Clinical side of how we run things.

    [00:17:50] Whitney Owens: We've had to do some policies surrounding communicating with clients. Um, so it's been really great for me, because prior to that, I was doing it and I wasn't doing a very good job at it because I had so many things I was managing. Um, and it's just not my skill set to tell you the honest truth. And Julie has such a great skill set when she writes these policies.

    [00:18:09] Whitney Owens: I'm like, wow, like, you wrote that so well, like, communicated it so much better than I would have. And so it's great to have her. Putting these in place, and she writes them and presents them to me, and we review them and make sure that, you know, it's always good to have a 2nd set of eyes on anything, right?

    [00:18:22] Whitney Owens: And then we present those to the team at the next staff meeting. And we have a whole folder within the Google drop where we put all those policies and procedures as well. So, the other thing you do a good bit of is the clinical supervision.

    [00:18:36] Julie Roberts: Yes. So I would say at least 20 percent of my. Thank you. Weekly duties would be clinical supervision, which I absolutely love.

    [00:18:45] Julie Roberts: So that means overseeing our internship program, and that could be a counseling intern, or it could be a master of social work intern. Also our associate level practitioners. I meet at least weekly or every other week with them, depending on where they are in the licensure process. I also run a external, um, clinical supervision group for, um, social workers who are trying to get their independent licensure.

    [00:19:18] Julie Roberts: So, I like the different mix of the levels of. Uh, clinicians, so I have learners that are novices that are still in college learning how to do counseling all the way up to people that are seasoned. Of note, we also run a licensed clinician supervision group, which I love and here's why I am a lifetime learner and I learn no matter how long you've been in the field.

    [00:19:48] Julie Roberts: It's extremely important that you continue to get supervision. And so what we did is we started a monthly zoom call. So, everybody that is independently licensed. We get on a call and we talk about, you know, what are some clinical case issues that we want to talk about, um, just using each other's expertise and knowledge because we all have different subspecialties and it really helps because it's providing a really comprehensive look at how can we see this case differently.

    [00:20:26] Julie Roberts: Very helpful. And then the other part of my job. And this is not so sexy but it's really important. Quality improvement. Many people say, well, what, what kind of quality improvement can you do in a private therapy practice? What do you think, Whitney?

    [00:20:43] Whitney Owens: Oh, lots of it. I'm sure.

    [00:20:45] Julie Roberts: So 1 thing that I do, um, and this has been a year long project is standardizing documentation.

    [00:20:52] Julie Roberts: So that meant writing a policy that talked about what are the expectations clearly in a policy of. How long does a clinician have to complete their note and I'm old school, so I was taught if you don't chart the intervention never happened. Okay. So, for me, best practice is you get the note in before you leave for the day.

    [00:21:18] Julie Roberts: Now, I noticed that's a Julie standard and not everybody can do that depending on what your caseload is. So, we made standards of all chart notes, intake notes, therapy notes, all have to be completed within 48 hours of that client session. There was pushback from many of the therapists because they thought, you know what, that's impossible, that's too strict.

    [00:21:46] Julie Roberts: But the goal was to get at least 90 percent compliance. of our charts reviewed that would fall within the 48 hour time frame. So up to date, we've been able to meet that goal. How is that done? I learned about quality improvement and chart reviews from working at big academic centers. Where you learn about a process, you identify a problem, and then you figure out what are the constraints, what are our goals, or what do we want to measure.

    [00:22:19] Julie Roberts: So for our practice, it was measuring the completion of progress notes. After that, we wrote the policy. And then I was able to create a tool that I could do samples and I recommend samples of looking at clinicians charting and making sure that it's random. It's very much impossible to be able to look at every single chart that your clinicians are charting in.

    [00:22:45] Julie Roberts: So take a goal, you know, look at it monthly, um, 10 percent of your therapist charts. And you're looking at things such as timeliness was the chart note completed within that 48 hour time frame. You're also looking at is the diagnosis appropriate. So, if you have clinicians that aren't coding any kind of DSM 5 diagnosis, that's something that I would look at, because in supervision, I would talk to that clinician and say.

    [00:23:19] Julie Roberts: Let's talk about, you know, your comfort level with complex diagnoses. So, helping clinicians to identify, you know, what is that broader diagnosis? And then as you get to know the client, how do you fine tune that, you know, and get a better clinical picture? I'm also looking at language. How do we write the note?

    [00:23:42] Julie Roberts: Are we writing the note, I saw this? You saw that or are we writing in the third person? Okay, or using things like therapist or writer observed client to be Having a high level of stress as evidenced by so teaching clinicians to use true clinical language also consistency of abbreviation okay, because Abbreviations can be confusing and if each clinician uses their own abbreviations Um, it just leads to reading of the charts being very confusing.

    [00:24:19] Julie Roberts: Okay. So, for example, eating disorders, and that's what we would clarify within this clinical setting. If you were in a medical setting. Ed would be erectile dysfunction. And so that's why it's critically important that you're clear about, you know, what do your abbreviation stand for?

    [00:24:43] Whitney Owens: Emergency department.

    [00:24:45] Whitney Owens: Yes. People use it

    [00:24:46] Julie Roberts: for that too. Yeah. Yes. Or even, um, bx, I see some therapists use bx. And they're using that to say behavior, but in the world of medicine, a BS, sorry, a BX is a biopsy. And then also looking at making sure that the therapists have a solid clinical plan in their notes. For example, every note, I believe should have.

    [00:25:16] Julie Roberts: A follow up plan as well as when do you see the client again and that date of the next session is put into that plan or that last part of the note. Um, that's really important that you add that because if the particular therapist. Is not available, or if a person gets sick for a week or 2, you know, because we're humans, whoever is reading your charts needs to be able to understand.

    [00:25:42] Julie Roberts: What that plan is, and what the intervention is charting is a nuisance, but it is a necessary evil so that we get paid, you know, as clinicians or through our, our payer sources, but also it's a professional courtesy. If you care about your coworkers. If you care about your clients, you get your charting done, you know, because if 1 of your clients calls the office in crisis, and your administrator, or whoever answers your phones.

    [00:26:15] Julie Roberts: It takes that call it is a courtesy that your administration person can look and say, oh, I see you have an appointment scheduled tomorrow. I will make sure that Amanda reaches out to you. But it also provides better care.

    [00:26:31] Whitney Owens: Oh, yeah. For the clients. Absolutely. It's embarrassing to pick up the phone and not know.

    [00:26:36] Whitney Owens: I don't know when your next appointment is. I don't know when you're coming in what's going on in your case definitely. And even as, you know, on my end, when I'm going through and running numbers and figuring out, okay, I need to make sure everybody's seeing the right number of clients, all that kind of thing.

    [00:26:51] Whitney Owens: I do go in and look at that stuff. And if it's not there, it's very confusing.

    [00:26:55] Julie Roberts: Right, and then the other key part of something that I teach. The clinicians that I supervise, I teach a lot about risk management or crisis care or situations where you really want to be mindful of what you put in the chart and what you don't put in the chart.

    [00:27:15] Julie Roberts: And I think, especially working with couples. It's pretty easy to put a lot of judgment and judgmental language versus being objective, you know, and I hope that I'm able to repair the relationships with the couples that I work with, but that doesn't always happen. And so, if I'm working with a couple, and they decide to separate, and then that goes into divorce or custody issues.

    [00:27:46] Julie Roberts: I want to be very clear about how I charted that I charted objectively without judgment. All important things, right? Because our words are powerful and they can really hurt our

    [00:27:58] Whitney Owens: clients. Oh, yeah, definitely and we have a whole policy about what to do when your charts are requested and all those kinds of things.

    [00:28:05] Whitney Owens: I wanted to point out a few other things that you do, Julie. She also does trainings like when people reach out wanting trainings for the practice, um, so she'll do those. And recently, I guess it was back in the fall. We did a training for school counselors. Yes. And Julie helped put together a whole risk assessment training and also our policy that we have here at the practice from people called needing those assessments, how we kind of go about getting those people scheduled.

    [00:28:32] Whitney Owens: And so she was a big part of doing that. So she does, does those trainings outside of the practice and in the practice, right?

    [00:28:38] Julie Roberts: And it's important that school counselors have that practical, updated clinical skill set training. Because what I've noticed and from talking to other school counselors, so whether they're counselors, social workers, psychologists, So much of their ability to practice is dictated on the school system.

    [00:29:02] Julie Roberts: So many times school counselors don't feel like they have the ability to be able to assess students that are at risk, or they feel like their hands are tied from an administration that. You know, if a child is sent to them who is verbalizing threatening behaviors, then the school district will ask that an incident report be filled out and that child be pulled out of school.

    [00:29:30] Julie Roberts: And sometimes that process that's automatic can cause more harm and make that child's, um, you know, crisis even worse.

    [00:29:41] Whitney Owens: Another thing that Julie also does is staff meetings. Um, so she's kind of in charge of helping run those. Sometimes I run them. Sometimes she runs them, but helping with the curriculum.

    [00:29:50] Whitney Owens: We're actually making a change this year. Last year, we did staff meeting every other week, and it was always a little bit more. Administrative in nature as we're kind of reviewing policies, what's going on at the practice. Um, but then this year, we're going to based on a survey, actually, Julie created and put out to the team and some feedback.

    [00:30:08] Whitney Owens: We got, we're going to have staff meeting still every other week, but we're going to alternate what we're doing. So, once a month, in essence, we'll be doing an administrative type meeting, reviewing things going on within the practice policies, things like that. And then the other week of the month that we have staff meeting.

    [00:30:25] Whitney Owens: It's going to be more clinical in nature, so it'll be having staff members share their expertise with the group. So we, for example, we have someone who does. So she's gonna be talking to the team about how to effectively know when to refer out for and they'll refer to her for that and vice versa.

    [00:30:41] Whitney Owens: Another therapist who does substance abuse. He'll talk about how to assess for that and your intake sessions, and then we'll also have experts in the community that she organizes and has them come in to be able to present to the team. So that's another big part of her role,

    [00:30:53] Julie Roberts: right? And what's important is that the trainings are relevant to your staff.

    [00:30:58] Julie Roberts: It's 1 thing just to put on a training, but it's important to get that feedback from your staff about what they want to learn. Yeah,

    [00:31:06] Whitney Owens: definitely. And another thing I wanted to point out here that I get asked this a lot by practice owners is. The owner doing the supervision, you know, and and I can see why people want to do that because when you're a very small practice, you don't really have the funds to hire somebody to do the clinical supervision, or you're capable of doing it yourself.

    [00:31:27] Whitney Owens: So, you might feel like it'd be better that way, but truly, there's definitely some considerations there. The idea of the owner also doing the clinical supervision, it can be kind of a conflict of interest really. For a therapist might not feel comfortable telling their boss everything going on, right? The dual relationship.

    [00:31:45] Whitney Owens: Definitely. Definitely. In fact, in the state of Georgia, lot of laws have been coming down the pipeline starting January 2024. And one of them was really not wanting the director to also be the clinical supervisor. I also just think as a business owner. I can think clinically, and I do love when my team comes to with clinical situations because I don't see a lot of clients anymore.

    [00:32:06] Whitney Owens: So I really enjoy that work. But also, I have to think differently. I have to be thinking about the practice and where we're going and how to meet the needs of the team in a different kind of way than a clinical supervisor does. So I think that it's advantageous to have both or if you can't. Have 1 in your practice, refer out and get somebody supervision outside the practice of clinical supervisor that you trust.

    [00:32:30] Whitney Owens: I think having both both sets of eyes and minds working together is really helpful for the team.

    [00:32:37] Julie Roberts: And normalizing that supervision is something that's important. So there was a time where we would have therapists that they would put clients on their schedule before doing supervision. And Whitney and I both believe that.

    [00:32:52] Julie Roberts: Clinical supervision is as important as seeing clients definitely, you know, and it's a good way to provide self care. It increases your skill set. It helps you from a burnout perspective, because you're able to talk about, you know, are there particular clients that are triggering for you? Um, you know, what are some things that you're struggling with?

    [00:33:17] Julie Roberts: I also use a supervision agenda, and that's not to be rigid, but it's more so a documentation tool that each supervision session, I document an agenda of what we talk about. So, that way, the therapist as well as myself, we have written documentation of what we talked about, but also, if you have a supervision agenda, it helps your supervisee.

    [00:33:43] Julie Roberts: To, you know, work on these are the things that we need to cover and it provides good continuity. Um, and supervision is not just talking about cases. It's also ethical issues. It's also, you know, clinician well, being, you know, how are you coping? I saw you got 7 clients this week. Yeah. Um, and my, my background is, I would describe myself as a motivational interviewing type of supervisor where I meet people where they're at.

    [00:34:15] Julie Roberts: Um, And work with them. So even one supervisees make mistakes, or they make decisions that make me cringe inside. We work through it and I don't judge, you know, I talk about pragmatically. What's the impact? What can we do different? You know, how do we learn from our mistakes versus being afraid to make mistakes?

    [00:34:36] Julie Roberts: Mm hmm.

    [00:34:37] Whitney Owens: So true. Well, this has been a full a full episode of lots of knowledge and information, which I don't expect any less from you, Julie. Um, but is there anything else that we missed that it's important about your job? You want to make sure to let people know about, you know, keep an

    [00:34:54] Julie Roberts: open mind. Um, over the years, I have interacted with so many wonderful mentors and clinicians.

    [00:35:03] Julie Roberts: But I want to stress to you that is what's important is not only being a clinician, but understanding the, the backbone of how do you do this work and how do you provide quality clinical care, you know, and that quality clinical care comes from how we document, how do we treat our colleagues. How do we educate our staff?

    [00:35:27] Julie Roberts: How do we interview and onboard staff? Yeah, you do that too. I forgot about that. We created a whole new onboarding system where it's formalized and, you know, many therapists that I work with, they say, you know, I went to school, I went to graduate school because I want to work with people, but there is such a need for the back end of, you know, compliance.

    [00:35:54] Julie Roberts: Looking at legal issues, HIPAA, um, and really being a resource to your practice. So, and not everybody can wear 2 hats and I acknowledge that too. That's why I called myself a

    [00:36:07] Whitney Owens: unicorn. You, you are a unicorn indeed for many hats. I feel grateful to have you. Thank

    [00:36:14] Julie Roberts: you. I'm glad to be

    [00:36:14] Whitney Owens: here. Yeah. Well, thank you so much for taking the time to be on the show.

    [00:36:18] Whitney Owens: I know this has been really helpful for practice owners. Um, and if y'all have any follow up questions, you can feel free to reach out to me, Whitney at whitneyowens. com and happy to answer those. And thanks for being

    [00:36:27] Julie Roberts: on the show. Thank you for having me.

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    [00:36:52] Whitney Owens: Special thanks to Marty Altman for the music in this podcast. The Wise Practice Podcast is part of the Sitecraft Podcast Network, a collaboration of independent podcasters focused on helping people live more meaningful and productive lives. To learn more about the other amazing podcasts in the network, head on over to sitecraftnetwork.

    [00:37:12] Whitney Owens: com. The Wise Practice Podcast represents the opinions of Whitney Owens and her guests. This podcast is for educational purposes only, and the content should not be taken as legal advice. If you have legal questions, please consult an attorney.

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WP 69 | The People in Your Practice: Understanding the Role of Therapist with Hunter Bickers