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[00:00:00] Dr. Sharp: Hello, everyone. Welcome to The Testing Psychologist podcast, the podcast where we talk all about the business and practice of psychological and neuropsychological assessment. I’m your host, Dr. Jeremy Sharp, licensed psychologist, group practice owner, and private practice coach.

This podcast is brought to you by PAR. PAR offers the SPECTRA™ Indices of Psychopathology, a hierarchical-dimensional look at adult psychopathology. The SPECTRA is available for paper and pencil assessment or administration and scoring via PARiConnect. Learn more at parinc.com\spectra. For a limited time, you can get one free administration and score report for the SPECTRA on PARiConnect by calling PAR at 855-856-4266. Just mention the promo code S-P-E-C.

[00:01:00] All right, y’all, good to be back with you today for another business episode. Today’s business episode is covering a topic that comes up a lot in my consulting and a topic that often comes up in the Facebook group as well. That topic is how to transition from a practice where you’re seeing some or maybe many therapy clients to a practice where you are only doing testing or nearly exclusively doing testing.

A few things that I’m going to talk about today are one, the very first step that you need to take to start transitioning to an all testing practice. I’m going to talk about a good timeline for transitioning. I’m going to talk about how and when to tell your clients about your transition among other things.

For me, I mapped this out into a 7 step process. I’m going to go through each of those steps in hopes that you can learn a little bit [00:02:00] about transitioning to a testing practice if that is something that’s on your mind.

If you have not checked out The Testing Psychologist podcast for CE credits, just a quick reminder that nearly all of the clinical episodes are available for CE credits at athealth.com/thetestingpsychologist. There’s a link in the show notes, of course. And you can get some CE credits for a podcast you’re already listening to. So, check that out if you need some CE credits. I know that ours are coming due here in August and you might be in a similar boat.

Okay. Without further ado, let’s talk a little bit about transitioning to an all testing practice.

[00:03:10] Okay, so here we are. I want to talk with you like I said, just about this whole process of transitioning to an all testing practice. Now, some of us are fortunate enough or decide to just launch an all testing practice from the beginning. And that is fantastic. And some of us, on the other hand, myself included, got into more of a general practice before transitioning to an all testing practice. And that’s really what I want to speak to today.

What I found, and again, this is part of my personal journey as well, is that therapy is amazing. I’ve had amazing therapeutic experiences. I am very fortunate and grateful for the training in the therapeutic intervention that [00:04:00] I got over the years in grad school and afterward. At the same time, it did not fit it. It didn’t fit for me after two years in private practice. I know for a lot of you, it ends up being less of a fit for you as well. So, that’s what we’re diving into, this process of how do you transition away from doing therapy when you’re seeing folks who most of the time are pretty invested in the therapeutic process and want to stick with you.

As far as I was concerned, I think I’ve talked about on the podcast before that I had more of a generalist practice in the beginning. I certainly saw a number of individual therapy clients. And I put a great amount of time and energy into getting trained and almost certified in emotionally-focused therapy for couples.

Now, what I [00:05:00] found is that doing this kind of work on a day-to-day basis on top of doing testing was pretty draining for me. The emotional output was extensive. I had a hard time. In the evenings, I would come home and basically just collapse on the couch and not have a lot to offer with my extroverted wife. And that did not go over very well.

So, I was headed in that direction of transitioning away from therapy. And then, our son was born, our first kid, and I found that I really enjoyed being able to be home and write my reports from home and that just fit better for my lifestyle. So, a few things coalesced to point me in this direction of transitioning away from my therapy clients.

Now, this is a hard process. When I embarked on this [00:06:00] process, my caseload was easily 20 therapy clients a week. So it took quite a while. I didn’t have a great idea of how to do it in the beginning, but as I went through that process, things became more clear. Here are a few things for you to consider if you are thinking about giving up therapy and moving into a testing-only practice.

The first thing that you want to do is set a date for your transition. This is going to be a date that is ideally about six months out from the present. I think six months is a good runway to do all the preparation we’re going to talk about, to have some conversations with your therapy clients, to prepare them appropriately, and to [00:07:00] refer them elsewhere if you need to do that.

So, the first step, like I said, is just to identify a date when you want to say, okay, I am going to be done with therapy on this date. And like I said, shoot for about six months out. Now, some circumstances might allow you to do three months. Some might dictate that you do nine months or even 12 months, but I think six months is a good, solid runway.

The second step in this process is deciding how many therapy spots you actually want to keep if any. If you don’t want to see any therapy clients, that is totally fine. No judgment there at all. That is the direction that I went. But if you do want to keep a few, then you need to decide how many you want to keep. As you go through this process, I would advise not making that decision based [00:08:00] on current client acuity or severity or which clients you “like” the most.

The truth hopefully is that most of us if we’re seeing therapy clients, we like them and we’re invested in their treatment. So, I don’t know that that metric is going to help you whittle down your therapy caseload because it’s hard, right? It’s hard to say, I don’t like this person or I really don’t want to be seeing this person. Maybe there are some clients like that, but that can be a tough one. So like I said, I would not go by client acuity or which clients you think you like the most.

What I would do is, I’d try to be as objective as possible and genuinely tap into what you want your professional life to look like. So independent of any [00:09:00] clients that you’re seeing, just think, how much therapy do you want to be doing?

And that’s a great time to check in and decide for yourself what kind of therapy you want to be doing. So maybe you transition, if you are going to see a few therapy clients to more of a solution-focused approach or a brief therapeutic approach, more of a cognitive-behavioral or a manualized approach. Who knows what it might look like, but this is a good time to just check in and see for yourself, how many therapy spots do you really want to keep?

Now, once you have determined how many therapy spots you want to keep, then I would suggest moving head on your calendar to that date that you decided on and I want you to set your ideal schedule. So keeping in mind how much testing you would like to be [00:10:00] doing or need to be doing either being driven by income or just lifestyle or choice, whatever it may be, but set up your ideal schedule, prioritize the testing, make sure to include time for report writing. And when you have devised your ideal testing schedule, take a look and see what is left for therapy. And I want you to be very deliberate about where you put those therapy slots on your calendar.

What I found in working with folks is one big barrier to transitioning to a testing practice is that therapy clients are sort of strewn throughout the day at sometimes regular intervals or times, but more often it’s a little more haphazard where people are plugging in therapy clients whenever they have [00:11:00] an opening and there’s not as much rhyme or reason to it. That’s why I say I’d love for you to jump ahead and set your ideal schedule, prioritize the testing and then define 1, 2, 3, 5 however many therapy spots you actually want to see and put them in spots that you want to see them. Are you better in the morning? Are you able to do therapy in the evening? That is not me, but if that’s you then capitalize on that.

I would encourage you just like any other event on your schedule or opening on your schedule to have it be consistent from week to week or every other week or bi-monthly, whatever schedule you want to set up, but make those spots consistent and tell yourself that you are not going to deviate and put people into other openings. So that’s step three, [00:12:00] set your ideal schedule and put those therapy slots where you want them to be.

Step four is thinking through which clients you want to keep. Theoretically, you have now reduced your therapy spots from whatever it is now to 1 or 2 or maybe 3, who knows, but the idea is that you have reduced your therapy spots. So you’re going to have to call your list of clients a little bit and decide if you’d like to keep any of your current clients.

Now, this is the place where you now have a pretty definitive number of therapy spots to work with. So, now you can go through your list of clients and say, okay, who do I want to keep?[00:13:00] Not just how many clients, but who? Which ones are, you can use any number of things, higher acuity, the ones that feel like the best fit for you. Personally, where I would go is all along the lines of doing the work that you really love to do. So which clients do you love working with that are a really good fit for your skill set, your personality, the connection, and so forth. So, think through which of these therapy clients you want to keep and identify those clients.

Let’s take a quick break to hear from our featured partner.

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All right. Let’s get back to the podcast.

Step five is now we have to figure out what’s going to happen with the clients who are not sticking around. This might be a lot of clients who aren’t sticking around and that is totally okay. There is nothing wrong with you. You are not a mean person. You are not a bad clinician. You are in fact going to be a better clinician because you are zoning in on the work that you actually want to do.

This is the place where a lot of folks will have some guilt and feel pulled to continue to see therapy clients. And that’s totally understandable. And it also is nothing about you. It does not mean anything negative about you that you want to move in that direction.

So what we want to do [00:16:00] is put together a really solid referral list and have that ready. Now, through this process, I’m sure most of us have a good referral list for our clients or our evaluation referrals. But when you think about referring out any existing therapy clients, I think this is a place to really put some energy because you want to be able to tell those clients that you’re referring out, that you have thoroughly considered what they need, and you put together some referrals that are truly a great match for them. That’s what we’re shooting for.

So really be deliberate in putting together this referral list. I would not just hand the referral list to the clients that you are terminating with. I would talk with each individual client and say, here’s what I’ve come up with. I’ve really thought through our work together and I’ve thought through the folks available in the community and I’ve come [00:17:00] up with 2 maybe 3 other psychologists or therapists who could be a really good fit for you based on what I know about you.

So you’re not just throwing a random referral list and say saying good luck. You are almost doing a concierge referral process where you’re going to do a warm handoff for the folks that you’re terminating with.

All right. So then, step six is informing those clients who will be leaving your practice what that’s going to look like. I would shoot for three months out. So three months out from your termination date or your transition date, I would inform those clients that you’re going to be transitioning to testing only, and that the [00:18:00] work together is going to end.

This can be a hard conversation, especially if you’ve been working with folks for a long time or depending on client characteristics. That can be a really hard conversation. And that’s why I think it will go a long way to have a little bit of a script ready in case clients want to hang on. Some will want to hang on. Some will ask why. Some might challenge you pretty extensively as to why you are terminating with them. So I think it makes a lot of sense to have a script ready for when those times come up.

You don’t have to use this script exactly. For me, it was something like, client, I want you to get the best care possible. And what I found is that my heart and my skills lie in assessment these days. [00:19:00] Continuing to do therapy would make it hard for me to bring my best to the work knowing that my passions are elsewhere. I want you to see somebody who is 100% invested and up to date on therapeutic interventions so that you can get the absolute best clinician possible.

Now, that script may not work exactly for you, but that’s where I landed. And I have discussed variations of those ideas with most of my clients and it generally went well. I did have 1 or 2 clients who I’d worked with for a long time who had a hard time transitioning, but for the most part, this was helpful. And I think folks just want to know that you care about them and that they’re not a throwaway relationship. And so that’s [00:20:00] what this is about. So again, at least three months out from the termination date, I highly recommend starting that conversation.

Now, some folks will want to terminate right away and your caseload will have some natural attrition. That is totally fine. Oh, and that reminds me, I should have said this in the beginning, but once you set your transition date, so maybe that’s that six-month out date, do not take any more therapy clients on. At that point, when you decide you’re going to transition, you are not allowed to take on any new therapy clients. That should go without saying, but I want to make that absolutely clear.

So, you’ll have some natural attrition about three months out. Again, you’re going to start having this conversation with your current clients. That gives plenty of time for [00:21:00] referrals and you can avoid any concerns for abandonment and that sort of thing. People often get concerned about clients being abandoned, but if we have conversations three months out, we provide solid referrals, you could do warm handoffs. If folks are really having a hard time, you can put plans in place for anyone who might be struggling to think about terminating.

So three months is plenty of time to lay some of that groundwork and provide for a smooth transition. That also gives you plenty of time to process the therapeutic relationship and actually go through a termination process. So, depending on what kind of orientation you’re working from, that could be more intense than others. But three months is usually a pretty solid timeframe to [00:22:00] actually terminate with these clients in a good way.

Okay. So that’s three months out. And then from there, I really think of it then, as you’ve started your final descent and you are gliding or coasting into the airport and you just need to land the plane. And you will get closer and closer to your transition date. At one month out, if you are going to be keeping any of your therapy clients, I think it is really helpful to start transitioning those clients into their new time spots. 

If you remember back on step three, we determined where you want to see any continuing therapy clients. So at about one month out, you want to start transitioning any therapy clients who are going to stick around into [00:23:00] their new time spots. So that should give them plenty of time to adjust their schedules and prepare for that transition.

Okay. So that was a really quick overview of the now proprietary 7 step process for transitioning to an all testing or a limited therapy practice, at least.

Again, just to recap. Step 1, set a date for your transition. Step 2, decide how many therapy spots you want to keep if any. Step 3, set your ideal schedule and put those therapy spots where you want them to be in your schedule. Step 4, think through any therapy clients you want to keep. Step 5, put together a solid referral list and have that ready. Step 6, inform any clients you’re going to be terminating with at three months out. [00:24:00] And then step 7, at one month out, transition any existing or continuing clients into their new time spots.

So hopefully this has demystified the process a bit. I just want to close by saying that it is totally doable. It does take time. So, if you have therapeutic relationships with folks, it can take time. And it’s I think, respectful and meaningful to end that therapeutic relationship in a deeper and genuine way. I think we owe that to our therapy clients in many cases, but it is completely doable. And by doing some planning, like I’ve laid out here, you can feel a lot more deliberate in this process rather than just kind of shooting from the hip and hoping that it works out.

Thank you as [00:25:00] always for listening. And like I said in the beginning, if you have not visited athealth.com to check out the CE credits, please do so. Almost all of the clinical episodes are available for CE credits. You can check those out and get some CE credits for a podcast that you’re already listening to.

Thanks as always y’all. I will be back with you on Monday with another clinical episode. Until then.

The information contained in this podcast and on The Testing Psychologists website is intended for informational and educational purposes only. Nothing in this podcast or on the website is intended to be a substitute for [00:26:00] professional, psychological, psychiatric, or medical advice, diagnosis, or treatment.

Please note that no doctor-patient relationship is formed here, and similarly, no supervisory or consultative relationship is formed between the host or guests of this podcast and listeners of this podcast. If you need the qualified advice of any mental health practitioner or medical provider, please seek one in your area. Similarly, if you need supervision on clinical matters, please find a supervisor with expertise that fits your needs.

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