If you're a therapist in private practice you'll find Nicole Amesbury's story inspirational and helpful. If you're asking yourself how to start a private practice, or how to grow further once you achieved success, Nicole will have great insights for you; she's been in private practice for many years, and is also, together with Dr. Irvin Yalom one of the founders of Talk Space. Nicole Amesbury is an existential psychotherapist in private practice providing individual care in the areas of relationships, work and identity.
Her core experience is on the development and use of technology in mental health services as well as technology's impact on our mental health. As an early pioneer of online therapy, she has worked helping build platforms to deliver services to people worldwide and has treated clients in 53 countries.
About the 6-Figure Practice Program:
The Six Figure Practice with Sasha Raskin, is an online program and community for helpers such as counselors and coaches, who are building their private practice. If you’re looking for a clear, step-by-step road map for creating and marketing your private practice, you're at the right place!
Free resources to grow and market your counseling private practice or coaching business:
Free 22 minutes crash course - "How to Create a Thriving Counseling / Coaching Private Practice": https://www.the6figurepractice.com/free-22-minute-crash-course
Free resources about marketing for therapists and marketing for coaches: https://www.the6figurepractice.com/blog
Free 30-minutes strategy session with Sasha Raskin: https://www.the6figurepractice.com/schedule-a-free-30-min-strategy-session/
Our accelerator program for creating a 6-figure business:
The 6 Figure Practice Program: https://www.the6figurepractice.com/the-6-figure-practice-program-accelerator/
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My name is Sasha Raskin. I’m a Number 1 Best Selling Co-Author in 12 Countries, a Doctoral student in Counseling Education and Supervision, a coach, a psychotherapist and an adjunct faculty at a graduate counseling program at Naropa University.
One of the things I’m enjoying the most is helping other therapists and coaches build their successful private practice so that they could actually help the clients they were taught to help, and thrive themselves. I’m almost always fully booked, so my ability to work with individuals is limited. That is why I’ve created this program to deliver powerful results and create a community where you will feel supported by each other!
This program's primary goal is to help you build a thriving private practice, in a fun and authentic way. Counselors and coaches invest an incredible amount of time, money, and effort into building their helping skills. However, when their training ends, they usually find themselves lacking the business skills that are needed to start and run a successful private practice, feel isolated, discouraged and not knowing where to start.
I believe that to be truly helpful to others, therapists and coaches have to learn to thrive themselves and definitely know how to get clients whom they can help.
This is where this program comes in. If you're willing to learn and work hard, a 6-figure private practice is within your reach in a year - 2 years. This program will give you a clear outline, and detailed instructions on how to get there.
Start and succeed in private practice - Interview with Nicole Amesbury of the founders of TalkSpace
Sasha Raskin: Hi, Nicole.
Nicole Amesbury: Hi, Sasha.
Sasha Raskin: I'm looking forward for our conversation today. So as you know, the listener, our podcast is mostly about tips and inspiring stories for therapists and coaches to help you in your journey, both in terms of what to do, how to do to grow your private practice but also to hear from other therapists that know the road ahead and maybe expand kind of the range of possibilities of what's out there and what your journey can include. And Nicole, we connected with you I think on Facebook, and when you mentioned all the things you done I was like, "Okay, this is the perfect person to interview for my podcast." So take it away and maybe say a few words about who you are, who you help, what do you do.
Nicole Amesbury: Well, at the core of all of it I'm a person, but I'm a psychotherapist and I do private practice. And my private practice is with individuals with an existential, psychodynamic, humanistic kind of foundation really. And in addition to seeing my individual clients, my journey has been with technology, and of course, that's expanded dramatically recently with the pandemic, but I started back with that almost a decade ago so long before everyone was Zooming, when there was just Skype and just texting I started out with a focus on online therapeutic practice. And that's been a core of my work which I still see clients online today.
Sasha Raskin: That's wonderful. So you were one of the pioneers.
Nicole Amesbury: Yes.
Sasha Raskin: Yeah, it's so important. It's been such a common thing in coaching, just phone calls for decades already and then video calls. And it kind of sounds like you were a big ... you had a big influence with your projects that you were involved with, bringing it into therapy which allows so many more flexibilities in terms of working with rural areas, for example, that don't have any therapists around them.
So maybe rewind, what do you remember from beginning your private practice before we get to the exciting stuff like your involvement with basically one of the founders of talk therapy, right?
Nicole Amesbury: Yeah, TalkSpace.
Sasha Raskin: TalkSpace.
Nicole Amesbury: I worked with them for years.
Sasha Raskin: Now people who are listening to this podcast interview and thinking how to start a private practice and want to learn from what you know, what do you remember about that period, that first year or first half a year?
Nicole Amesbury: Yes, it was a little bit of a strange story actually. I live in Saint Augustine Beach, Florida which is kind of a smallish area. It's growing, but at the time it was quite small. And I was working at a community mental health practice, and really a lot of people from rural areas would come and I saw the barriers that people had to getting and maintaining healthcare, mental healthcare. Really just to see a therapist was a challenge. So it wasn't very inspiring work, and then of course with some funding issues the place where I worked as an employee went out of business, they had to close suddenly.
Sasha Raskin: Interesting.
Nicole Amesbury: And that was really disheartening as an idealist, a young therapist who wanted to change the world and then all of a sudden I'm out of out of a job. And it was so not what I expected or wanted it to be like. And so I found myself with a colleague of mine who also had just lost her job there sitting on my living room floor like a couple of days after the place had closed suddenly, and what are we going to do? And of course, those patients that we saw there we didn't want to abandon them, they suddenly didn't know where to go and we had done the outpatient portion of that. And so even though we didn't really have much and we're frightened we said, "We can rent some office space and let's just roll up our sleeves and get to work. Have as many of the people that couldn't be served by this place anymore so that we can help them at least somehow, and see if we can grow a practice." And so it was really out of necessity that I started a private practice.
Sasha Raskin: Interesting.
Nicole Amesbury: And not expecting to take that way at all, but it was good. It was good, it was necessary. And around this same time was when I was on Facebook and it was a little bit before the place actually closed that I had seen a Facebook post by Dr. Irvin Yalom that talked about this new ... his experience on online therapy through Skype, that somebody was trying to do something more with it and it was called Talk Tala at the time, and if any therapists were interested in contacting the founder to get involved, they could. And I did. It was interesting, it was sheer interest that made me pursue it and also the fact of this previous experience that I saw how many people weren't getting care. And I knew from taking graduate courses online that this was possible. And so I thought, "Well, why not give it a whirl?"
Sasha Raskin: Yeah.
Nicole Amesbury: And it was very small. And so as I'm working my private practice and helping here in person locally I was also helping with that, and of course, it was so early stage, there were only a few people, and there's no money involved at that point, it was sheer like just inspiration for wanting to see where something could go and how it could be built and what problems could be solved.
Sasha Raskin: I love that, Nicole. So two projects that you started that good things came out of it, the TalkSpace and it was called differently back then and your private practice. When I talked to counselors especially before they joined our private practice accelerator, the 6 figure practice program, there is this fear unless they already have been in private practice for a while, the fear of starting something new. And if we look at the business life cycle just like families have life cycles and humans have, that first initial step, the birth, it's around like the big thing there is risk and the perception of risk - do I go all in and try this thing out and do I make it happen? Or do I go with whatever feels like the safest option which like in your case wasn't a safe option, right?
Nicole Amesbury: Uh-hmm.
Sasha Raskin: I get a safer job and then they closed all of a sudden. So can you tell me how were you able to start two new projects despite, well, with the private practice probably some fears around will it work or should I go and maybe work at a different agency, and the other thing, getting involved with a new project, I don't know, I assume some counselors might think when they see a post like this from Dr. Yalom, who am I to even reach out, right?
Nicole Amesbury: Uh-hmm, yeah.
Sasha Raskin: So the imposter syndrome that can kick in. How did you work with starting something new in both of those cases?
Nicole Amesbury: Oh, goodness, I think for myself I've always been a little bit of an explorer and extremely curious, and so that probably helped me as a kind of resiliency into that, but really out of just the need of other people. I wasn't really so much thinking about the risks that I had to take, I was thinking initially when these people wouldn't be served I worried about them, I worry about others.
Sasha Raskin: I love it.
Nicole Amesbury: And what are we going to do to help them. And knowing just that there's, and I think this is true in mental healthcare, there's just so many people that need help that aren't getting it. You have a place if you're a therapist, you really do.
Sasha Raskin: I love that.
Nicole Amesbury: You can help someone. And how you grow that is up to you because the area is so vast, there's almost too much possibility that you have to kind of ... because as I grew I had to realize I have to make choices here. And as businesses grow they have to kind of know like what populations do they want to work with, what do they want to specialize, how does that look like? And so really it was I was just propelled by helping other people. I wish I could say that ... I mean, maybe the risk, I was a little bit younger, maybe I wouldn't take the same risk today, but knowing myself I may just do it. But it has to inspire me.
Sasha Raskin: I love that. So you focused on helping other people versus on your own inner process.
Nicole Amesbury: Yeah. [Unclear/cross talking 10:58]
Sasha Raskin: I'm sorry?
Nicole Amesbury: For better or worse.
Sasha Raskin: Yeah. One of my coaches, [unclear 11:05], he says when you get anxious about your business not growing as fast as you want or just not growing, just focus on service and then helping people. Because that's what it's all about and that's what it's based on.
So I recorded this podcast episode and I gave it a slightly provocative title to get slightly more attention, right? It's selfish of you not to start your private practice, just ... but the idea though is whether it's private practice or an agency if you already put in like three years as a therapist in training or even if you're a coach and there are some really good coaching programs out there, and then after all this effort and the hundreds of hours in internship you're deciding to play small and not go and work in the profession, in a way it's a disservice to all the potential clients you could be helping and it's just a waste and it's a shame.
Nicole Amesbury: Honestly, yes. I mean, everybody needs to find their place of what types of people they work with best.
Sasha Raskin: Exactly.
Nicole Amesbury: And give their best. But I think that it is a shame.
Sasha Raskin: At least trying, right?
Nicole Amesbury: Yeah.
Sasha Raskin: For science sake.
Nicole Amesbury: For science sake. And at the heart of it, throughout the course of my life I've had helpers along the way and that's such an invaluable piece to this, is that we're here to help others and then in turn maybe not in from the same source it's given back.
Sasha Raskin: Yeah, I love that. What would you say after starting your private practice and getting involved with TalkSpace at the beginning stages of it was your next milestone in growing in your profession, in your private practice? And in any other projects you got involved with.
Nicole Amesbury: Yeah, well, when I worked for TalkSpace I worked as a contractor the whole time. I mean, that's most start-up's work, although I was working exclusively with them. And I think that the next kind of milestone was feeling almost in the beginning like was a little bit of an imposter syndrome, like what right do I have to try to do this. And then luckily, I ended up working with Dr. Yalom, for years we would have a video conference, one for an hour every other week for years. And he was a wonderful colleague and mentor and friend. And that relationship, working relationship, really ended up changing who I am as a therapist and my work and greatly influenced me.
And of course, then once the company grew to a certain point, all good things must come to an end, and I decided to take an exit and was then started ... because I think it's very important for people who are in private practice to have someone who is a clinical supervisor or anchor or at least a group that they meet with, because as therapists we need that and you would languish if you were alone. And so I do work with Ellen Josselson who Irv works with but he's very old now and has other projects, so I started working with her. And then working with other start-ups and businesses, consulting in the online behavioral health space.
Sasha Raskin: I love that. So your relationship with Dr. Yalom was around TalkSpace or was it more supervisor, supervisee or colleagues?
Nicole Amesbury: It was around TalkSpace and the development of if you're going to create a company with this, you know, although online therapy or remote therapy has been done for a long, long time, I mean, if we trace it back I think Jung had letters he wrote to a patient through snail mail. And then, of course, therapists have kind of grappled with this through the phone and things like that. But if you're going to make it with technology nowadays and you're going to scale it, you need to make sure that it's done obviously ethically, obviously the highest standard you can. And of course, with technology one of the good things that's possible is really out having more information about outcome measures and how do we even become better therapists with the data and information that we can use.
And so all of these areas of like how do we do it really well and how is it like traditional therapy and how do we take the kind of techniques and tools and refashion them for this new environment. So we worked on all of those kinds of things with of course real case examples that we would talk about every week.
Sasha Raskin: I love that. Were you thinking at that time maybe I'm taking on too much? Well, I have my private practice here that I'm developing, and should I even get involved in another project?
Nicole Amesbury: I found the other project so satisfying and inspiring and so much more opportunity was there I just kind of naturally got pulled in that direction. And so I needed to make a commitment to that. It was really just feel ... I didn't think I was taking on too much. Of course, through the course of it, it went from ...
Sasha Raskin: Yeah, just a little bit to I don't have time to eat lunch.
Nicole Amesbury: So yeah, so I mean, you talk about kind of a birth and it does feel like labor at times, it's very, you know, you can feel the growing of something and then there's kind of a lull and then you feel another spurt of growth and then [unclear/cross talking 18:06]. And you have to learn how to manage those feelings and thoughts and kind of the ... sometimes you might have a sense of like all of this is going to fail horribly or what am I doing here, but those are just ... most of those are based in fear, and fear isn't something we necessarily have to give in to, is it?
Sasha Raskin: Yeah, that's the definition of courage, right? Taking action despite the fear, not the absence of.
Nicole Amesbury: Yeah, I mean, there's always doubt, fears and insecurities and things like that. And you just have to think about what's realistic. It's usually not your worst fear. I mean, you know this.
Sasha Raskin: Well, and easier said than done, right? What would be your advice for therapists that especially at the beginning of their journey, the professional journey, after training sometimes paralyzed by fear. For example, I see that all the time when therapists join our private practice accelerator some of them actually have a pretty decent base for their website but they're paralyzed by the thought of publishing it and putting it out into the world or what will happen if. What are your thoughts on specific ways to work with the doubts?
Nicole Amesbury: I mean, I could see where you say if I put something out in the world, if I publish my website or whatever, what if it looks horrible, what if there's a bug? And that may very well happened, it happens all the time. And then you fix it.
Sasha Raskin: Sounds very simple. Nicely said, Nicole. And then, you fix it.
Nicole Amesbury: And then you fix it. I mean, it's not like you're not going to have stumbling blocks on the journey, you absolutely are, you're going to have people telling you that you can't possibly do it. I mean, that's something that we confronted with online therapy. And I look back at it, I don't want to have resentment about it, but originally people were saying, "How could you even do this? It wouldn't be effective? It wouldn't be normal." Because it was innovative and people have fear of change. And of course, through all of the last year when it's the only way you can communicate now it's widely, widely accepted.
Sasha Raskin: It's the catch 22, people do what they're used to doing just because it was done the same way yesterday.
Nicole Amesbury: And so just like we tell our clients in order for change to happen you need to get a little uncomfortable. Even though we're therapists we're not immune to this feeling that I have to do something or it might be in my best interest to do something even if it's uncomfortable, even if it doesn't look pretty and it's a little messy. Because the greater thing is that I can then manage it.
Sasha Raskin: Nicely said. With time I learned to recognize that feeling, that little, not anxiety, but the hesitation, like the tightness in my stomach and the thoughts of maybe tomorrow as a green light, okay, this is the sign I should go for it.
Nicole Amesbury: People really coil at feelings of anxiety. They really seem to coil at them or want to push like this myth that we could live an anxiety-free life. And when you can really embrace your anxiety like that I feel like that's what anxiety's really there to do, is to help you to live, to help you to go forward. And so you just have to listen to it very carefully.
Sasha Raskin: I love that. Yeah, it's just your body getting ready for action.
Nicole Amesbury: Yes, exactly.
Sasha Raskin: Which is not the worst thing when you're about to take action. So we're kind of doing a quick overview of all your professional journey and we're still at the first year, two years of your private practice and getting involved with TalkSpace. What would you say were your main challenges and how you overcame them, business-wise as well?
Nicole Amesbury: Business-wise as well, originally I put too much emphasis on not taking care of little things that would annoy me.
Sasha Raskin: Oh, okay, the operation side.
Nicole Amesbury: The operation side in my private practice. And in retrospect, if I could go back in time I'd change that, but I can't, this is advice for other people - I wish I had taken myself, I wish I had done things like paid very good attention to my taxes and how I ran my LLC, just very practical stuff, but [unclear/cross talking 23:32] as much.
Sasha Raskin: But it's the boring stuff, right? Why would you focus on that when you can help people?
Nicole Amesbury: Well, because, I now know because it's very important to do so. So knowing that you do have to do some of the boring stuff anyway and get through it is something that I think I struggled with.
Sasha Raskin: I'm so glad that you're pointing it out because I see that both in therapists who are just starting out or already have even a group practice and they don't have the foundation in place. So in the 6 figure practice program we use this model, a triangle, you have your operations, you have your marketing and your sales, right? So therapists in private practice they usually focus just on the marketing part - how do I get found? And even that part is not well thought of, they usually count just on one strategy that kind of works randomly versus have a consistent stream of clients that find them. But the sales part is not taking care of because, well, we are therapists, we don't need to sell, right? And the operations part is not taken care of. And then burnout kicks in, right? It's like I'm spending 20 hours helping clients so my dream came true and my practice is full, but 10 hours additionally I'm doing the operations part, a lot of manual labor and kind of trying to keep it all together.
That's why I'll actually share something personal - when I was building a private practice accelerator I was really thinking about what's the right order for all the models. And like my gut feeling was we need to take care of the operations part in model one, week one. And then I was thinking, "Well, it's kind of boring and not exciting. I want to get people who join, therapists and coaches, get excited and start finding clients as soon as possible." So I had a lot of back and forth with myself and I did a lot of iterations. And I just decided, "No, it feels a little bit more boring," but actually once the operations part is done a lot of the anxiety is taken care of because you knkow that when what you wish for comes true you won't pay the price for it with a lot of manual labor.
So I think I made a good decision with that, and it's great to see therapists who take their business as a business not as a hobby.
Nicole Amesbury: Exactly. Foundation will serve people later.
Sasha Raskin: Any other challenges you're thinking of back in the day?
Nicole Amesbury: Well, I think other than that it wasn't so much ... well, let me think. Probably as I look over time one of the challenges was just really being able to be open with clients about the financial aspect of the working alliance and relationship.
Sasha Raskin: Interesting, say more about that.
Nicole Amesbury: Yeah, I think a lot of people have trouble talking about money, and you mentioned the sales portion, why would therapists need to do sales? Well, they're selling their services and they feel like it's a nasty word and there's something wrong with it. And people need to know what you're offering, and so I think there's the part of that that's like a marketing piece, that's a larger piece of sales, but then actually speaking with clients about their financial lives is something I think therapists don't do.
Sasha Raskin: Yeah, they don't go there.
Nicole Amesbury: They don't go there. And it's so important because in your own ... for your client it's important but for your own business it's important because it does things like manage dropout rates of people who they don't want to tell their therapist some aspect of their financial life, they can't afford the fee anymore so they just would leave or something like that. Whereas, the more open you can be with your clients about a financial situation the more you can have a better outcome and they'll probably stay longer.
Sasha Raskin: I love that, and you're modeling that it's to talk about money. I literally have clients that would tell me about like a very deep trauma like first session and in my mind I was like, "Okay, hold your horses." But they won't talk about money for a year if I don't go there, right? It's like a bigger taboo than sexual trauma or anything else. Money.
Nicole Amesbury: Yes, it is, and yet it's something that people really struggle with. I mean, we have people who commit suicide; a lot of them do so when they're in financial peril. It's something that needs to be talked about.
Sasha Raskin: Many times I would offer to my client as a resource free financial coaching. That is, for anyone who's listening, it's probably available for you too in as part of the taxes you're paying to your county. That's usually a service that's offered for free by the county, that's paid by your taxes. It would be good for you and would be good for your clients, and it's free which is kind of awesome.
So fast forward let's say three years. What would you attribute the growth of your private practice to? Maybe some specific things, mindset things. Where were you clients finding you from? How are you able to grow, etcetera?
Nicole Amesbury: Well, I don't know if the timeline is exactly like you said, but then when I decided to exit working for TalkSpace that had been such a huge project I had to admit to myself I was a little burnt out and I wasn't quite sure exactly what things were going to look like next.
Sasha Raskin: Yeah, that's a tough truth to admit, for a therapist, right? It's like, "I talked about burnout all the time with my clients, but look at myself."
Nicole Amesbury: Yeah, you're supposed to be strong for everyone.
Sasha Raskin: Exactly.
Nicole Amesbury: I struggled with that of I am a very strong person, that doesn't mean that you can't suffer from burnout a little bit. And so I needed to take ... I kind of fought that feeling, I didn't want to admit it.
Sasha Raskin: Yeah, me neither, same thing.
Nicole Amesbury: I don't want to admit it. And then but once I did that was a good thing. I could take a little ... I could give myself a little bit of grace, take a little bit of time, think about what I wanted to focus on next.
Sasha Raskin: I love that. So actually a part of your growth was de-escalating the growth, right? Kind of slowing down and asking yourself the important questions.
Nicole Amesbury: Really important questions, yeah.
Sasha Raskin: And what were your answers that you found?
Nicole Amesbury: I think a question was should I just go out and get some other ... what should my career look like now. And I have lots of decision making over things like, "Well, would I want to move from where I live now?" Because this is not the valley where I live. "What is my life going to look like? And should I just really scale down to something and be employed by someone? Should I continue? Should I start getting patients in person again?" Because it had been a while since I had seen in-person patients. And after a lot of reflection, I mean, I found out to really embrace what I enjoy. And one of the things is I see clients from all over the world, English-speaking but from different countries, and I really enjoy that work tremendously, it gives me satisfaction. And so I wanted to embrace a lot more.
I had one project I was working on that I decided I'm just going to put it on hold. It was a personal project and I said, "I'm just going to put it on hold for a while. I'm just going to let it sit. And I won't beat myself up about it and see what happens there." And then I did a little, I did some projects with some other start-ups and they're not always ... I had to confront the fact that they're not all going to be as successful as each other because I'm not the only person driving it of course, but would they be satisfying and would I be able to help in a way? And so I kind of grappled with that. And what I really learned is that I enjoy the individual sessions with clients just more than any other part of it, that's what I enjoy the most.
Sasha Raskin: Yeah, beautiful. It's interesting. It kind of flips, right? At the beginning when you're just starting out your goal in a way is to say yes to everything. "Okay, I'm going to try this thing. I'm going to try this thing." But the more you grow the more successful you become, whatever success means to you, you start ... it's kind of like your responsibility, my responsibility is to start saying no to more and more projects, potential clients, whatever. So I need to be really, really clear on my priorities. And it sounds like your main priority was what do I actually enjoy the most. Kind of as simple as that.
Nicole Amesbury: It's very much ... there's a lot of truth in what you're saying, because I am definitely a yes person, and I think a lot of therapists and helpers ...
Sasha Raskin: Of course.
Nicole Amesbury: They want to say because they want to help people.
Sasha Raskin: Exactly.
Nicole Amesbury: But there does come a time when you really have to use your nos wisely. And that was a little bit challenging for me, and yet it is a marker of some success.
Sasha Raskin: It is, it's a quality problem to have, right? I see that with after a few months to a year the therapists and coaches in our program they fill their practices, whatever full means to them. Usually it's 20 to 30 clients a week. And then they have a high quality problem. Well, where do I go from here? And I think it's a wonderful next stage in your development which usually involves either some group work or scaling down, setting like very clear non-negotiable boundaries, for myself, for example, no more than 20 hours a week of private practice, just nothing more than that. Or online products or doing some consulting work, like you got involved with a lot of projects. Or hiring a team or creating a group practice.
And it's interesting, usually it's the things that got therapists do that let's say for the sake of measuring it let's say 100K a year revenue just as a way to measure it, what got them there is usually what's going to stop them from getting to the next level, whatever their next level is, which is trying to do everything on your own, right? Saying yes to everything and just counting on yourself to do it all.
Nicole Amesbury: Absolutely, absolutely.
Sasha Raskin: What do you think about that?
Nicole Amesbury: I can completely agree with that. And I see that clearly in business, the yes, yes, yes. And it is like it's building, it's building and you can feel the pressure. And you know you have to switch something. There is this time when it seems like it's you've grown and now it seems like it's falling, it could seem, like it's falling apart or it's going to come off the rails. And it's not necessarily.
Sasha Raskin: Exactly.
Nicole Amesbury: Not necessarily.
Sasha Raskin: Unless you keep on doing the same thing and then it might.
Nicole Amesbury: Yeah, if you do the same thing. And then you just have to really think clearly then and you have to realize that it's a good problem. Haven't done anything wrong.
Sasha Raskin: Just the opposite, you actually did some really good work.
Nicole Amesbury: You actually did something right, but what it's going to look like now because it can't ... it's going to evolve at some point and it's going to ... it's not going to stay ... just by the nature of the business it's not going to stay stagnant like that. It's a moving thing. And so you have to make those decisions. And I mean, obviously hiring someone and making a group practice is very different than some other avenue you may take like doing group work. So you really have to be thoughtful about what do you want your life to look like, what do you want your working life to look like? And those bigger questions of, "Well, really how do I define success? Is that making then even more money or is it being content with what I have and what I do and scaling back a little bit and maintaining?"
Sasha Raskin: Yeah, that's a great question. And how do you know? What would be your advice for therapists that maybe suffer from the dichotomy of I either help people or I either charge for my services and sometimes neglect that part of their business? Not necessarily doing just pro bono but maybe being underpaid or not taking care of charging people up front or not upholding their boundaries with late cancellations, like one hour before the session.
Nicole Amesbury: It's really helping people, it's really helping your clients to have these conversations and for them to value you. There's lessons there about how we value each other, and it's just so critical to talk about that. Our clients themselves have a lot of concerns often, boundaries in their own life. And so if you look at it from a point of view that you're really modeling good behavior for them then it creates a sense of security in the relationship and it ends up being more ... I know the fear is there, but it ends up being more manageable when you bring it to light.
Sasha Raskin: Yeah.
Nicole Amesbury: Really. And the harsh realities of life is that not everyone can afford $100, $200 an hour for a therapist, that may be true and that people's financial situations change, but also, I don't know how many times I've seen this story where you have a client that's complaining about your fee which is rather low let's say and they're complaining about it and then in the next session they're talking about, "Oh, I went on this vacation somewhere or I went to this restaurant," and as a therapist you hear that and you can't help but think to yourself, "Well, if they can afford all of these other things, what is this that they can't? Is it not valuable?" And then you have to look into yourself and say, "Well, how valuable is my service?"
Sasha Raskin: Good point.
Nicole Amesbury: What are they taking out of it? I mean, people will pay, I don't know, it depends, a lot of money to get their hair or nails done quite often and a gym membership is something to look at. I mean, people pay for services for personal services all the time, and it really strikes me that therapists don't value their personal service more when they are also legitimate healthcare providers.
Sasha Raskin: Exactly right. So what's that about?
Nicole Amesbury: I wish I knew what it was about. I think for myself when I remember I went in, I entered into a hospital ... Sorry.
Sasha Raskin: No worries.
Nicole Amesbury: I went into a ... for me what it's about is I could recall going into the hospital where I worked as an intern, and this was before I graduated with my masters, and I did a year internship in a hospital. And my periphery, right? I didn't get paid for the internship. And I actually paid for provision, so I'm paying ...
Sasha Raskin: I paid for my internship too.
Nicole Amesbury: And I loved it, I absolutely loved every moment of it. It taught me, it was satisfying, but it also sent some kind of a message. I remember talking to my supervisor and him saying, "You don't get into this profession for the money."
Sasha Raskin: Oh, yeah, that's a dangerous message.
Nicole Amesbury: And it was a really dangerous message.
Sasha Raskin: I would be scared if that would be the only reason that someone goes into being therapist, just the money, right? But like pushing this idea away that you need to be paid for your time and effort, that's kind of ridiculous especially usually when putting 100K into three years of education plus living expenses plus the sum cost of not working full-time for those three years.
Nicole Amesbury: It's a ridiculous message. And for therapists that feel, I don't know, I guess weird about charging, and I don't know why you would, I mean, you're a professional. But I've often said to my clients, "Because it's a caring profession. You have a relationship with someone." So if you're a good therapist you really do care, but, and I'm sure other people have heard this before, they're not necessarily paying for your caring, they're paying for your time and you're taking an hour out of your day or however long your sessions are and it's the time they're paying for.
Sasha Raskin: And usually they're paying for years not even an hour, right? Within that hour you're using skills and experience that you've been acquiring for years.
Nicole Amesbury: Yes, absolutely. And your fee should be reflective of that.
Sasha Raskin: So let's fast forward to today. What are the projects you're involved with today or are you doing just one-on-one therapy? How does your week look like?
Nicole Amesbury: Well, I'm fielding offers, I've got some meetings set up recently with some other start-ups to talk about consulting projects, and those usually ... they're not long-term things, they usually help in one area.
Sasha Raskin: That's exciting, you get in, you get out.
Nicole Amesbury: Yeah, I get in and get out. And that's nice because I can manage it. I set a little bit of time aside for that. And then the rest of it right now is individual one-on-one clients. So I'm enjoying it. I'm enjoying it a lot. But I think in the future I know it's going to look different in the future. I'm focusing, a project I did put aside for a while was writing and I'm doing that now.
Sasha Raskin: Oh, beautiful. You're writing your book?
Nicole Amesbury: Yeah, but it was a long journey. It's a terrible thing.
Sasha Raskin: Writing a book.
Nicole Amesbury: Terrible, horrible, heartache.
Sasha Raskin: Yeah, why would people do that?
Nicole Amesbury: Why would anyone do that to themselves?
Sasha Raskin: Yeah, I have two books like ready, like one is edited and one is like I'm going over the last edit and it's like, "Ugh, just putting the period on it and getting it published already."
Nicole Amesbury: And I've had friends, it's nice to have writer friends because like they may submit a manuscript and then it doesn't get published or something like that and you realize you're not alone, so I mean, that piece of work it really is a joy.
Sasha Raskin: What is your book about I'm curious?
Nicole Amesbury: Therapy. Therapy, of course.
Sasha Raskin: That's a good subject for a therapist to write about.
Nicole Amesbury: It's something I worked on for a long time and I really did just have to put it away for a while because it just didn't suit me to ... that was actually when you talked about that question of like what do I do next, kind of, that was one of my things I had to say not a yes or no, I had to say not yet because I didn't want to give up on it. But I also knew that right now other things took precedent in my life. And people have families, other than just your work you have your families, you have your other interests and things, and therapists have to know how to ... like you can't just work all the time, you have to have a balanced life in order to have a long career.
Sasha Raskin: Yeah, I love that. And it's so different, like having a shelf for things that are just not a priority right now versus not finishing your website, same example, because you get scared a little bit, right? Very different things, right? By decision or by impulse.
Nicole Amesbury: And over the years I'll do little things like I keep a paper calendar, weekly, day minder, and I've kept one for every year. And I can go back and I can reflect and see what kind of things look like. Same thing with like your tax records where you can go back over time sometimes like a diary and look back and see your growth over time and how you made those decisions or if they were impulsive.
Sasha Raskin: I love it. What would be your advice for a therapist or even a coach who's thinking how to start a private practice?
Nicole Amesbury: What would be my advice for someone on how to start a private practice? Well, I mean, obviously you help people with that. And I think just initially doing the research but not doing too much research, you could get lost just ...
Sasha Raskin: Oh, good point.
Nicole Amesbury: And with all the types of choices you have to make it can be very overwhelming. And I would say make a choice and carry it out and don't question it all the time. You get a choice, guess what? You get to make more choices. But to kind of stay stagnant, wondering if I should or if I shouldn't, that is like the worst.
Sasha Raskin: And I'm a couple's therapist, I see that as the biggest problem with couples when they're on the fence - should I stay or should I leave, right? And then they're not invested in the relationship and they're not living either, so it's this limbo that creates suffering really.
Nicole Amesbury: It really is, it's a purgatory. And even if you made the worst choice it would lead you in a direction and you could make another decision or you could repair it, you could do something. But just to sit in that what should I do mode next is it is a true purgatory.
Sasha Raskin: I love that. It's the danger of the illusion that planning equals execution, right? It's not. When you're planning and researching you're not doing even if you're spending hours and hours reading articles, it doesn't get you one step closer to your private practice. I love what you said about like do some initial research but it's just like one small step to start with and then just start doing.
Nicole Amesbury: Absolutely. It has to be that way. And just starting somewhere because like should I start with marketing, should I start with some sort of sales or should I ... do something in the right direction. If you're moving in the right direction you're moving.
Sasha Raskin: I love that. It's interesting. I don't know if it's related, but yesterday I heard just like some different inspirational talks about starting your business and Dana White who's kind of the owner of UFC, mixed martial arts, like some brutal sport, right? He was using the same words that you just used. Just start, do something, fail, continue, right? So it's interesting, the same thing works for therapy and private practice as it works for mixed martial arts fighting in a ring. Just do something, learn from it and continue.
Well, Nicole, what would be your tip for someone who already filled their practice and they're thinking, "Well, where do I go from here? I kind of achieved what I wanted to at the beginning, I have more than enough clients. I know that I have incoming stream of clients constantly, but should I just keep at it or should I start something new?" What would be your advice for that stage?
Nicole Amesbury: I think my advice might depend on the person, because once you get that geared up feeling of growing some people will just keep going full blast and that can get a little hairy. I think for someone who's already grown their practice I think at some point they need to stop and ask themselves that question about success and what that really means to them.
Sasha Raskin: Yes.
Nicole Amesbury: I think one thing that's a tool that sometimes I use is when I think of my career I used to make decisions about like what do I do in the short ... I had more short-term thinking as to how to get through the next year or whatever. I think looking and saying, "Well, 10 years from now, what do I expect this to be like? 20 years from now, do I ever want to retire?" I mean, personally I don't, but ...
Sasha Raskin: Yeah, who wants that?
Nicole Amesbury: I really don't.
Sasha Raskin: Yeah, exactly.
Nicole Amesbury: But some people do want to retire. I think looking at both the short and long-term when you're thinking about growing to the next stage, where do you want to be as opposed ... I mean, because when you're just building at the beginning you are pretty clear, you set your foundation and you just need to build, get clients or like it's a career. When you get to that stage, well, what do I do next? I think you do have to look at the bigger picture, the long-term what you want your life to look like.
Sasha Raskin: Nicely said. Nicole, thank you so much for this interview. Very inspiring. If anyone who listens or watches this interview wants to contact you, either they want to hire you as a consultant or ask you questions, how do they find you and how do they contact you?
Nicole Amesbury: Well, right now since I'm very quiet you can find me on LinkedIn or via my email address which I don't know if you put it in the ...
Sasha Raskin: So it would be on the ... as a podcast episode which is also, so some people would be just listening to it, so if you can spell how they find you that would be awesome.
Nicole Amesbury: It's email@example.com.
Sasha Raskin: Could you repeat that again? I think it was cut out for a second.
Nicole Amesbury: firstname.lastname@example.org.
Sasha Raskin: Wonderful.
Nicole Amesbury: D and my name, Nicole Amesbury, @gmail. Yes.
Sasha Raskin: Perfect. Thank you so much, Nicole.
Nicole Amesbury: Thank you so much too. It was a pleasure speaking with you.
Sasha Raskin: Yeah, me too.