Return phone calls. Seriously. The number of clients who tell me that they are so thankful I called them back because prior to me, they called 5 other therapists who never got back to them. If calls are difficult, I’d recommend including your email on your voicemail so you can avoid phone tag and quickly send out an email between sessions or at the end of the day.
As a part of our interview series with prominent medical professionals called “5 Things You Need To Know To Create a Highly Successful Private Practice” I had the pleasure of interviewing Sara Ralph.
Sara Ralph is a licensed professional counselor (LPC) and owns Summit Grove Counseling, a group private practice in Bryn Mawr, Pennsylvania. She is an adjunct faculty member at Eastern University and Lebanon Valley College and manages Therapy Space King of Prussia, a shared office space for mental health professionals.. She loves strong coffee, early mornings, and going on outdoor adventures with her 3 and 5 year old.
Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you ended up where you are?
When I was in graduate school, studying for my masters in counseling, I had no desire (ever) to be a mental health counselor; ironic, I know, but my desire was always to work in higher education. I graduated during 2008- the height of the recession- and I wasn’t able to find a job in Louisville (our home at the time). We ended up moving back to PA (where I am originally from), and I took a position as an intake therapist for a community mental health agency.
A few years later, my husband was offered a job in the Philadelphia area, which also corresponded with my receiving my license (LPC). I joined a group counseling practice outside the Philly area and worked as a career counselor at the local community college. I enjoyed my work but still longed to be in higher education.
I was absolutely elated when I was offered a position at Eastern University, my alma mater, as the Assistant Dean of Students and Residence Director. I loved my work there and so enjoyed the capacity in which I worked with students. After my first child was born, we moved soon after so I could be home with him.
While this was wonderful and I thoroughly enjoyed my days with him, I also wanted to use a different part of my brain, so to speak. I began my solo private counseling practice in Bryn Mawr, PA in January 2017. The market here is a saturated one, and there were times when I considered closing my doors. However, within 2 years I was completely full and turning clients away regularly. My husband was the one who suggested I start a group practice. I was overwhelmed by the thought of it, especially because I had a newborn and a toddler at this point. But, hey, why not add to the chaos? 🙂
In January 2020, Summit Grove Counseling officially opened. Unbeknownst to me (or any of us!), the pandemic was right around the corner and the need for mental health services was about to grow exponentially. I hired my first contractor in Feb 2020, and she was full within a few weeks, so I hired another. She filled up quickly also. So, I hired another. And on and on.
We currently have 8 therapists with Summit Grove Counseling and are hiring again!
I’m a huge fan of mentorship throughout one’s career. None of us are able to achieve success without some help along the way. Who has been your biggest mentor? What was the most valuable lesson you learned from them?
I could never do what I do now without having had the experience in community mental health; that experience may be my greatest clinical asset. While I wouldn’t say I have one mentor, I have had supervisors and VPs and consultants and peers who have asked me hard questions, invested in me, and in one case, provided me with an opportunity of my dreams.
While my dad isn’t in the mental health field, he told me in my early counseling days, “Learn as much as you can about every part of the business. That way, you can do your own practice one day.” At the time, I had zero desire to have my own business. But, I heeded his advice. I paid attention. I learned various insurance terms, heeded advice of the QI team audits, and developed relationships for marketing purposes even when it felt very much out of my comfort zone.
What made you want to start your own practice? Can you tell us the story of how you started it?
I loved staying home with my baby, but, as many moms do in the early, monotonous days, I got bored. I needed to think in a different way (beyond nap schedules, feeding schedules, and laundry). I listened to podcasts while hanging cloth diapers, researched during nap times, and dreamed of the possibility of a “both and” life- creating my work to fit around my life and not the other way around.
Can you share the most interesting story that happened to you since you began your career?
Someone wanting to interview me about my success? I spent much of my first year in solo practice thinking about quitting. I have never intended to build anything big. When I first made the decision to grow from a solo to group practice, I had planned on 2–3 therapists max. Well, here we are at 8.
Because it is a “helping profession”, some healthcare providers struggle with the idea of “monetization.” How do you address the business aspect of running a medical practice? Can you share a story or example?
We all have our own personal “money stories.” Sometimes the therapist (me) has to consult with the billing/payroll department (also me) about how to handle a certain situation. Pre-pandemic, I ran a one-day retreat for therapists; one of my colleagues asked if she could receive a very discounted rate for others in her practice. I simply said, “The therapist part of me would love to be able to offer this to you, but the business part of me cannot do that right now.”
Managing being a provider and a business owner is a constant balancing act. How do you manage both roles?
I’m learning (and have learned) to hire out! I have lessened my client load and plan to not take on any new clients for some time. I think about what I like to do (counseling, marketing, retreats, etc.) and what I don’t like to do (data entry, insurance verification, billing); I simply pay someone else to do what I hate. Someone else can likely do the task much more efficiently than I can anyway!
From completing your degree to opening a practice and becoming a business owner, your path was most likely challenging. Can you share a story about one of your greatest struggles? Can you share what you did to overcome it?
My most recent struggle has been (and continues to be) balancing my work life with my family life. I love my work and I love being with my littles. I have more recently decided to delegate and outsource the parts of my work that are time consuming and, frankly, not enjoyable. Specifically, I have hired a Virtual Assistant. I cannot tell you the relief I feel knowing that help is on the way!
Ok, thank you. Here is the main question of our interview. What are the 5 things you need to know to create a thriving practice, and why? (Please share a story or example for each.)
- Return phone calls. Seriously. The number of clients who tell me that they are so thankful I called them back because prior to me, they called 5 other therapists who never got back to them. If calls are difficult, I’d recommend including your email on your voicemail so you can avoid phone tag and quickly send out an email between sessions or at the end of the day.
- Know your ideal client. Who do you want to work with and why? (Speaking of “why,” who or what is your “why?” Why do you get up and do your work?) My ideal client has changed a little over the years and may change again as I change both personally and professionally. There are many counseling generalists out there (and that is fine!), but you will likely have more success if you niche down.
- Take a risk. Make the leap before you’re ready. It’s okay if this is a calculated risk. I like the “idea” of risks, but I don’t always like actually taking them. Don’t let fear (or the pandemic) stop you. This summer, I’m going to sign a lease for a full office suite (3 offices). Can I fill all of the offices? Nope, not yet (because most of my therapists will remain virtual). But, I believe that I will one day.
- Delegate and hire out. Therapists went to school to be excellent in psychotherapy, likely not accounting, marketing, website design, etc. Know your strengths and don’t be afraid to delegate out. Hate dealing with insurance companies? (Me too.) Hire a biller as it will make you a better therapist!
- Maintain positive relationships with colleagues. There is enough pain to go around, so I never worry about our practice not having enough clients. With this in mind, if a potential client needs help we cannot provide, I happily refer out to other therapists; in return, others refer to us. Everyone wins!
As a business owner you spend most of your time working IN your practice, seeing patients. When and how do you shift to working ON your practice? (Marketing, upgrading systems, growing your practice, etc.) How much time do you spend on the business elements?
This seems to vary by season. I have structured my work days so that I am seeing clients in the afternoons only. I spend the mornings working on the business. My mind is always “working,” so it’s not unusual for me to spend time on the weekend working (know that I am not an advocate for working on weekends. My life is very full with two little kids, little childcare, and no pre-school as a result of the pandemic.)
I understand that the healthcare industry has unique stresses and hazards that other industries don’t have. What specific practices would you recommend to other healthcare leaders to improve their physical or mental wellness? Can you share a story or example?
Get a therapist. Slow down. Take a power nap. Drink a lot of water. Move your body (5 minutes between sessions is a great time to do some yoga poses as a way to ground yourself).
Can you please give us your favorite “Life Lesson Quote”? Can you share a story about how that was relevant in your own life?
“Trust the process.” My husband has told me this many times during the course of our marriage and my professional and personal development. I remember being stressed over passing the licensure exam (even thought I had studied well) and he reminded me, “Trust the process.” A few years later, I was nearing the day of running my first full marathon. I was nervous and didn’t quite understand why I had to taper my runs during the last week. Again, my husband reminded me to trust the process. If you prepare, the process can be trusted.
How can our readers further follow your work online?
Our website is www.summitgrovecounseling.com.