Author: Dr. Jeremy Sharp

Hello, everyone, and welcome to The Testing Psychologist podcast. I’m your host, Dr. Jeremy Sharp, a licensed psychologist, group practice owner, and private practice coach.

Many of y’all know that I have been using TherapyNotes as our practice EHR for over 10 years now. I’ve looked at others and I just keep coming back to TherapyNotes because they do it all. If you’re interested in an EHR for your practice, you can get two free months of TherapyNotes by going to thetestingpsychologist.com/therapynotes and enter the code “testing”.

This episode is brought to you by PAR.

The new PAR training platform is now available and is the new home for PARtalks webinars, as well as on-demand learning and product training. Learn more at parinc.com\resources\par-training.

Hey, everyone. Welcome back to the podcast. Thanks for being here. Always glad to be here with you.

Today we are talking about, what are we talking about today? We’re talking about one of the biggest decisions that we have to make as private practice owners at some point; and that is when to hire help or if we want to hire help.

This has come up a lot recently. I’m not sure if it’s part of the zeitgeist where everyone is feeling a little more overwhelmed or maxed out than usual. But if you have found yourself drowning in scheduling, billing, intakes, clinical work, and waitlist stretching out, if you’re feeling totally maxed out, you’re not alone.

In this episode, we will talk about both the qualitative and quantitative signs that it’s time to hire, how it feels emotionally when you’re taking on too much, and the key financial and operational metrics to tell you it’s time to bring in help. I’ll break down the numbers, the workflow challenges, and the real opportunity costs of waiting too long to hire. Plus, I’ll share strategies to overcome the fears and hesitations that I think a lot of us experience when making that first hire. So, if you’re on the fence about expanding your team or just curious about the best way to do it, stick around, and we will get into it.

Now, this and many other topics are just bread and butter for the consulting work that I do with folks. I’ve been running a testing-focused practice now for about 15 years and have been all around the block in terms of hiring, firing, strategizing finances, and all kinds of things. So, if you would like some support in your practice, I would love to connect with you. I’ve been doing these strategy sessions here lately over the last several months, and they have been great. I think they go really well. We dive in for an hour and try to answer a question or two and then send you on your way with some concrete strategies to move through your problem and do something different. If that is compelling to you, you can book a strategy session right from my website, thetestingpsychologist.com/consulting.

For now, let’s go deep into the feelings and the metrics of hiring.

All right, people. We are back.

Let’s talk about hiring. Hiring is tough. I’ve done a lot of episodes on hiring: the ins and outs of hiring, the finances of hiring, the how, the why, all those things, but it just keeps coming up, this question of how do you know when you’re supposed to hire? It’s a tough question. I did an episode relatively recently that gave a calculator about how to hire. That’s metrics-driven.

Today, I’m talking a little more in-depth about the feelings and then pairing that with some of the metrics behind it. Let’s talk first about the feeling part- the emotional component of hiring. How might it feel when it’s time to hire administrative or clinical help?

These are some signs of what I would call administrative overload.

1. If you are constantly behind on scheduling or billing or writing reports, that is one sign.
2. If you are dreading the administrative side of things more than the clinical work, that’s a good sign that you’re maxing out a little bit. 
3. If you find yourself losing mental bandwidth, if you are someone who typically has pretty good executive functioning, but all of a sudden, maybe not all of a sudden, maybe over time, you find that you are missing emails, you’re forgetting to return calls, you are dropping clients in the middle of the evaluation process and losing track of where they’re at, that’s also a sign that you might be maxing out on the admin side of things.
4. That relates to the last potential indicator, which is if you are noticing a decline in the client experience, and that could be long response times or inefficiencies in your process, or they’re getting annoyed they’re not getting their reports on time, things like that. These are also signs that you may be overloaded with administrative tasks.

As I discuss all this, I just want to normalize being overloaded with administrative tasks because we, just like running a business, nobody took a class or multiple classes in graduate school on how to handle the administrative tasks of a practice. I mean, nobody has had a class on being a project manager or an office manager or anything like that. There are whole degrees that correspond to this skill set. We don’t have those. So don’t feel bad if you feel overwhelmed by the administrative tasks.

Now, what about on the clinical side? We’re going to tackle admin and clinical.

On the clinical side, these are some signs that you might be overloaded clinically.

1. Your schedule is consistently booked out, consistently being the keyword here, year-round, through all the cycles of the season. Your schedule is consistently booked out beyond 4 to 6 weeks.

2. You are feeling emotionally drained or resentful seeing clients. This is an easy one, but also one that we can endure for quite a while. So if you’re getting the Sunday scaries or you think about not wanting to go to work, been there, that is a sign you could be clinically maxed out.

3. You’re turning away cases. That’s a very concrete experience. You’re turning away cases because you don’t have the time to see them.

4. Lastly, if you find yourself not having time to keep up with referrals or business development or CEUs, this can also relate to being clinically overloaded and needing some help.

We all know this, right? I don’t need to talk about burnout or anything necessarily, but there is a real impact of overworking. If you’re under constant stress, which a lot of especially solo practice owners are, but group practice owners who have not delegated are also under a lot of stress. Constant stress leads to decision fatigue. To me, decision fatigue is one of the most insidious and detrimental experiences that we can have as practice owners.

Maybe you’ve experienced this: You work all day, you do everything for your practice, and then you come home, your partner asks what you want for dinner, and you melt on the floor. Now, I’m not saying I’ve had that experience or that I’m projecting my own experience onto everyone else, but if you’ve had that experience, you’re not alone by any means. Decision fatigue then makes it hard to do anything important when you have an important decision to make, not just dinner; it can really affect us. So, stress can lead to decision fatigue and burnout.

It can also, of course, lead to struggling to stay present and engaged during your work. If you are thinking about all those phone calls you have to return or emails you have to return or, my gosh, I forgot to send that person my questionnaires. That’s all part of the deal. It is distracting. And so, not only are you potentially doing yourself a favor, but you’re doing your clients a favor, too, by hiring some help.

And then, your personal relationships might suffer as well if your work is like creeping into everything.

I think we all know there is a definite impact of overworking, but it’s also easy to look past that and keep putting one foot in front of the other, from day to day, when things are not so great.

So those are a lot of the feelings. I’m guessing that some of you resonated with some of those experiences, and that’s okay. We’re going to talk about what to do about it. For those of you who are less feeling-oriented and want some metrics, let’s talk about some metrics in terms of knowing when it’s time to hire.

Here’s a revenue benchmark. This was interesting. I dug into some of the metrics here. I have opinions about all this, but I actually did some research to figure out when it might make sense from a revenue standpoint. It seems like if you’re at the point where you are making between $10,000 and $12,000 a month, it is a little bit of a no-brainer to hire admin help.

Where’s that coming from? $10,000 to $12,000 a month, this is estimating administrative costs to be about 5% to 10% of your revenue. Let’s just say, if you’re at $10,000 a month, that means you’d be spending between $500 and $1000 a month on administrative help. At that income level, that allows you to maintain a reasonable profit margin and still spend a relatively small amount on administrative help.

You might say, my gosh, $10,000 to $12,000 a month. What in the world? That’s so much money. If you’re doing 4 to 6 evals a month at $2000 to $3000 a piece, that easily equals $10,000 to $12,000 or even more. So at that point, like I said, you can set aside $500 to $1000, maybe a little bit more for administrative help. That should theoretically buy you anywhere from 20 to 40 hours over the course of the month for administrative help, which is often plenty for solo practice owners. And if you’re a group practice owner, you should be making a lot more than $10,000 to $12,000 a month.

If you wait too long to hire admin help, again, those inefficiencies creep in, and you end up costing more in lost revenue than the salary of that administrative person. If we’re talking $500 and $1000, for many of us, that’s like half of an evaluation. The benefit of having an admin person is going to, I assume they’re going to be booking at least one evaluation a month that you would otherwise miss.

All right. Let’s talk about time a little bit. If you are spending more than 5 hours per week, that’s 1 hour a day, people, or less than 1 hour a day if you’re working seven days a week. So, if you’re spending greater than 5 hours per week on administrative tasks, you are 100 % losing money.

This is basic finance. If you charge, let’s just say $200 an hour for clinical work, and you’re spending 5 hours a week doing administrative tasks, you are essentially losing $1000 a week in billable hours just for trying to save a little bit of money. This is anchored into plenty of financial data, accounting data, folks, mental health consultants, and so forth. I would almost argue that if you’re doing any administrative tasks, you’re losing money because you’re not going to pay any administrative person more than $200 an hour, but you are paying yourself that much if you’re choosing to do the administrative tasks. But we’ll keep it simple and straightforward. If you are spending greater than 5 hours per week or an hour a day on administrative tasks like answering phones, sending emails, doing billing, or doing scheduling, then you’re losing money and shooting yourself in the foot.

Now, what about clinical help? Let’s talk about the metrics behind that.

Again, a few weeks ago, I released an episode with a little calculator to tell you when you could hire clinical help based on your conversion ratio, inquiries, and things like that. But this is a little bit of a different spin. So again, looking into the data, if you have a waitlist that is consistently greater than 4 weeks, you are likely losing clients.

Now, we live in a little bit of a bubble in the sense that neuropsychological testing is typically booking pretty far out, and it’s rare to find someone who is less than three months booked out, but the data does suggest that if people have to wait greater than 4 weeks, they will likely go in search of another provider who can book them a lot sooner. So if they’re unable to schedule within 2 to 4 weeks, they often drop off and try to seek another provider. That’s why just calling back to, I think my episode last week or about 10 days ago, if you are on the phone with someone and they are not converting, perhaps because of the wait time, it might be beneficial to just tell them like, Hey, you can call around, but you aren’t going to find anyone who’s booking fewer than three months out. But again, if you’re booking farther than 4 weeks out, this might be when it’s time to hire clinical help because all in all, the sooner that you’re able to get people in, the more your business is going to grow.

If you have consistent referrals that exceed your available appointments, it just means that there is likely enough demand to sustain another clinician. So if you are turning away 5 to 10 clients per month due to lack of availability, that is $10,000 to $20,000 in lost revenue. And that could easily cover someone’s salary.

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All right, let’s get back to the podcast.

So where’s this coming from? Many folks running practices would say, again, this 4 to 6-week wait list, turning away at least five people a month, that’s when it’s time to hire more help.

All right. Let’s talk about referral volume a little bit more.

If you are getting more than five referrals per week, it’s probably time to expand. If you are converting five referrals a week, that is definitely enough, but if you’re just receiving five new inquiries per week, that’s 20 per month, and that’s generally enough demand to sustain another provider. I think most of us, if we’re doing comprehensive evals, you’re doing what, 2, maybe 3 per week. That’s a maximum of 15 people per month that you’re seeing, a 5-week one at three evals a week. So if you’re getting five inquiries per week, that’s at least 20 per month or 25 per month. That should be enough demand to start to build a caseload for another provider.

So again, these are not hard and fast rules, but they are reasonable thresholds to think about if you just need something quick and dirty to say, okay, it’s time for me to hire. So, if you’re getting greater than five referrals or inquiries per week, if half of those convert, that’d be like 10 a month. That’s going to be an additional

$20,000 in income. And, of course, if you are hitting that demand consistently over 3 to 6 months, I think you can be very confident in hiring another clinician to take on those referrals.

Let’s talk about another aspect from a workflow standpoint. If you’re so busy that you are not getting your reports turned around in three weeks or less, you’re likely running into trouble. Research, I think, has shown that the ideal report turnaround time is 2 to 3 weeks for a client and referral source experience. So if you’re greater than three weeks, which I’m sure a lot of you are, I’m sure some of you are out there listening like, my gosh, what? Yeah, you’re not alone. Plenty of people are taking longer than three weeks. I am just reflecting on the research. Let me be clear. There have been times in my practice where I am also taking longer than three weeks to get reports back. So I’ve been there. But if your report backlog is exceeding 3 to 4 weeks, that is a sign that you need some help with either psychometry or maybe some AI software or a report writer or an admin- something to help you get that back under control. So anything that can help delegate those tasks and cut off some time for you can be super helpful.

So I gave you a bunch of metrics to think about again, just quick and dirty cutoffs from a revenue standpoint: how much time you’re spending on admin tasks, how long your wait list should be, and your referral volume and your report turnaround. So if you need to, you can go back and relisten to the last 5 or 7 minutes and catch those numbers again. They are not hard and fast rules, but they will give you an idea of when you want to start thinking about hiring.

Let’s transition to overcoming some of the fears with hiring and taking the leap.

We are all, I think, hesitant to hire. There’s the fear of expenses, this is going to cost too much. I can’t invest it. I can’t afford it. What I would say to that is, can you see it as an investment in sustainability and profit and the long-term health of your business rather than the fear of the expense?

A lot of us have concerns about delegation. Oh my gosh. Y’all, I have so much control that I have to have. I have so many control issues. My poor family. A lot of us have this concern about delegation, right? To that, you could start very small. I think bringing on a clinician is a really big leap, but you could start small with a virtual assistant or someone two hours a week and almost wade into the pool of delegation. And as you learn that you can trust another person to do things, then that will be very helpful.

So that is related certainly to the control issues that many of us have. And to that, I would say the only way to work through those is to walk into the fire. So document your workflows and SOPs, build training resources, shadow that person, have them shadow you, and trust that there have been a million entrepreneurs and business owners who were scared to death to let anyone do anything in their businesses and they ultimately got over it and figured out that it could work well. So you can turn your control into a superpower and look at it more like teaching and mentoring than anything, if that helps.

Let’s talk a little bit about the first steps.

If you want to dive deeper, just as an aside, we can talk about money. I’ve done episodes on the money and how much it costs to hire people and that kind of thing. So, I’m not going to do that, but we could talk about that if you wanted to. I think there are other episodes that cover that. So, I’m going to skip over the money, but we will talk about the first steps: how do you hire smartly and then scale a little bit?

I think for most solo practitioners, I recommend hiring admin help first. I did a podcast episode with, I think it was Jessica Lackey, and she advised to go straight for your office manager, someone who can do almost everything and be very reliable and very actionable and responsible. That feels like a big leap for me. But I know it’s worked for several practitioners.

For the purpose of this podcast, if we’re just trying to wade into the pool of hiring, I think admin help first makes the most sense. You can start with a virtual assistant. It’s going to cost you $30 or $40 an hour, maybe a little more. They can help with scheduling. They can help with billing. You can offload your intake calls and your email communication. They can build email templates if you don’t trust them to answer authentically. They can also help you set up standard operating procedures based on your practice’s workflow.

I think a virtual assistant can do a lot and is a great way to just step in the hiring. If nothing else, they can send questionnaires because Lord knows it takes so much time, more time than it needs to, to send questionnaires and go to all the different platforms and log in and set up the questionnaires and so forth. So if nothing else, they can send your questionnaires. They can maybe even enter scores into tables if you have a set up the right way. So, you can get a lot out of a virtual assistant.

Now, on the clinical side, there are some options. You could hire a psychometrist. So this is maybe best for psychologists who want to see more cases without additional hours. So the psychometrist can step in and do the testing, or you can hire other clinicians, right? This gets a little bit more nuanced. Then we’re talking, okay, is this like a postdoc? Is it a licensed person? Then, we get into questions of expectations around supervision, caseload, and compensation. It all gets a little bit more complicated when you hire a clinician, but it is totally doable.

So, if you are pretty risk averse and you want to have or retain a little more control in your practice, I think a psychometrist is a great choice because you can supervise them and you can be very clear with them. They’re not a peer, at least from a licensure standpoint. So it gives you a little bit more agency to, I hate to put it this way, but tell them what to do. I think a lot of us don’t feel comfortable giving directions to peers or being a manager of a peer. And so a psychometrist can be an easy way to wade into the pool of hiring on the clinical side, and it frees up time immediately. And then you get some breathing room, and you get to decide, okay, do I want to use this extra time to see more cases or do I want to catch up on the work I’m behind on or do I want to use this time to live my life a little bit more?

So it can be done, folks. It can be done. I know this is a short and sweet version of how to hire, but I just want to continue to address mainly the emotional concerns around hiring. It is tough. I faced these problems when I first started. I waited way too long to hire.

There is something called the 80 % rule, where if you wait until you’re 100% overwhelmed, it is way too late. If you hire when you’re at 80 % capacity, it’s going to be a lot easier for you because then you’re going to have time to train that person, and you’ll have the bandwidth to mentor them, support them, onboard them, and all those things. So don’t wait until you’re 100% overwhelmed like I was. It was 2, 3, 4 years in my practice before I brought on someone to help answer the phones and help with billing. I wish I’d done it almost from day one, but I’m like a lot of y’all. I didn’t want to spend the money. I didn’t know how to train. I didn’t want to give up control, all those things. It is legit. Those are legitimate concerns, but totally overcomeable at the same time.

Again, hiring could be both a data-driven and an emotional decision. I know it’s hard to marry those two sometimes, but that’s what I’m attempting to do in this episode.

The one thing you might do is a quick self-assessment. You can run through it. You can look at the transcript and check for yourself. Are you experiencing any of those emotional components of burnout or being overwhelmed? Are you hitting the metrics that I mentioned for hiring on the clinical admin side? If you are, then let’s talk about how to hire. Let’s take some next steps.

You’ve got plenty of support. If you don’t have support from your peers or consultation group, check The Testing Psychologist Community and set up a strategy session. Like I mentioned at the beginning, it is totally doable and hope that you are able to find your way through this process and hire when you need hire.

All right, y’all. Thank you so much for tuning into this episode. Always grateful to have you here. I hope that you take away some information that you can implement in your practice and your life. Any resources that we mentioned during the episode will be listed in the show notes, so make sure to check those out.

If you like what you hear on the podcast, I would be so grateful if you left a review on iTunes or Spotify or wherever you listen to your podcasts.

If you’re a practice owner or an aspiring practice owner, I’d invite you to check out The Testing Psychologist Mastermind groups. I have mastermind groups at every stage of practice development: beginner, intermediate, and advanced. We have homework, we have accountability, we have support, and we have resources. These groups are amazing. We do a lot of work and a lot of connecting. If that sounds interesting to you, you can check out the details at thetestingpsychologist.com/consulting. You can sign up for a pre-group phone call, and we will chat and figure out if a group could be a good fit for you. Thanks so much.

The information contained in this podcast and on The Testing Psychologist website are intended for informational and educational purposes only. Nothing in this podcast or on the website is intended to be a substitute for professional psychological, psychiatric, or medical advice, diagnosis, or treatment. Please note that no doctor-patient relationship is formed here. Similarly, no supervisory or consultative relationship is formed between the host or guests of this podcast and the 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 an expertise that fits your needs.

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[00:00:00] Dr. Sharp: Hello, everyone. Welcome to The Testing Psychologist podcast. I’m your host, Dr. Jeremy Sharp, licensed psychologist, group practice owner, and private practice coach.

Many of y’all know that I have been using TherapyNotes as our practice EHR for over 10 years now. I’ve looked at others and I just keep coming back to TherapyNotes because they do it all. If you’re interested in an EHR for your practice, you can get two free months of TherapyNotes by going to thetestingpsychologist.com/therapynotes and enter the code “testing.”

This podcast is brought to you by PAR.

Use the Feifer diagnostic achievement test to hone in on specific reading, writing, and math learning disabilities, and figure out why academic issues are occurring. Learn more at parinc.com\feifer.

Folks, hello. Welcome back to The Testing [00:01:00] Psychologist. We’ve got a clinical episode for you today, and it is really good. I’m talking with Dr. Ben Morsa. He’s a psychologist in private practice in Oakland, where he provides psychological assessment, psychoanalytic psychotherapy, and consultation. He founded the group psychology practice, Tide Pools, in 2022. He’s currently working on a book called Farewell Diagnosis: Diffracting Psychoanalysis, Assessment, and Autism, which is under contract with Bloomsbury.

This is a fascinating conversation as you can tell from the title. We talk about marrying psychoanalysis and assessment, which on the surface might seem like a tough marriage, but after this conversation, I hope that you might arrive in a different place. I think that Ben and I get into a number of topics that are both fascinating and useful.

So we talk about some background in psychoanalysis [00:02:00] and what “modern” analysis looks like these days, we talk about the Rorschach as a natural bridge between analysis and assessment, and we talk about a number of analytical concepts or tools that we can employ in the assessment process that dovetails really well with my recent conversation with Dr. Stephanie Nelson and some of the other conversations on this podcast around doing a depth based assessment that goes beyond diagnosis.

I want to make sure and mention, because we don’t mention it during the episode, that Ben and a colleague are doing a day-long workshop at the SPA Conference in late March. If you are headed to the conference or maybe want to head to the conference for this workshop, I would highly recommend it. You can go to the SPA website and register for that workshop, and check it out. I hope that you find this conversation as [00:03:00] stimulating and compelling as I did with Dr. Ben Morsa.

Ben, hey, welcome to the podcast.

Dr. Ben: Thanks, Jeremy. Great to be here. I have been a long-time listener and eager to get it into our conversation today.

Dr. Sharp: Hey, yeah. Me too. I’m sure people see the title of this episode and wonder how we are going to marry psychoanalysis and assessment. And if I’m being honest, I’m wondering the same thing. I’m excited to have this conversation and see where we go. So thanks again.

I’ll start with a question that I always start with, and that question is, why this? When we’re talking about a podcast episode or even how you spend your life and your energy, why choose to focus on this particular topic?

Dr. Ben: Great [00:04:00] question. My undergraduate; first half of it, I was at a school that was very STEM intensive and so I did math, a lot of engineering, some pretty crunchy science. There was a part of me that always really loved and enjoyed that. The second half of my undergraduate experience was much more social science, humanities, philosophy. So I went in a very different direction, but ended up really loving both.

And that all came back around when I went to graduate school. My intention was to study psychoanalysis, to learn how to practice. I did that by way of becoming a psychologist. So I chose a clinical psychology program that was psychoanalytic in orientation, which was definitely still present, but not as common as it was maybe 40, 50 years ago in [00:05:00] clinical psychology training programs.

And so I showed up to my interview and the person interviewing me was like, clearly you’re interested in psychoanalytic and psychodynamic work, but you are aware that this program has a significant emphasis on assessment, yes? And truth be told, I was aware, but I was really hoping we wouldn’t get to that topic because I did not know nothing about assessment. I think I linked back to this experience of math and science, and curious about quantitative stuff. I must not have spoiled it too badly because I kept obtaining my doctorate there.

But it was something about my graduate training that really taught me about the possibility of having these two seemingly very different types of work in conversation with each other. Something about seeing that [00:06:00] modeled and present, and also learning about some of the history of folks who carry those identities; folks like Roy Schafer, more recently Phil Erdberg of the R-PAS world. He was what’s called a research analyst. So he was an analyst, but that was back when institutes kept things in a tiered system and you had to be an MD to be recognized as a true analyst.

Through a lot of rooting and digging around, I’ve found both other people who practice both, and a kind of training in early developmental community where I got to play with both. So that’s really what got me into once I got a taste of that, here I am.

Dr. Sharp: That’s fair. I’m curious about the state of analysis these days. I’m assuming, you look young and cool. People can’t see you have a mullet. It’s a fabulous mullet. And that tells [00:07:00] me that you maybe went to graduate school sometime in the last 10 to 15 years. I’m curious about the state of analysis these days and how it is being presented in graduate programs being that in my mind, we’re a long way divorced from the time when analysis was popular. So what was that like and how’s it showing up in graduate programs now?

Dr. Ben: That’s such a great question. I’m glad we’re getting into this topic because like a lot of systems of thought and practice that enjoy their moment in the spotlight, there’s a rather arrogant history to psychoanalysis that I think many people respond to and many folks are understandably put off by. Analysis is much more than that narrow slice of experience, and I think particularly in the contemporary moment.

I imagine a [00:08:00] number of your listeners, maybe you are familiar with Nancy McWilliams. She’s a psychoanalyst out of Rutgers. She’s written now a quantity amount of essential text, psychoanalytic diagnosis, psychoanalytic psychotherapy, psychoanalytic case formulation. She released one on supervision during COVID.

She’s someone you can look at on YouTube and you can listen to her talk about, she’s talking about analysis, but she doesn’t draw a hard line between analysis and therapy, which already represents something new in analysis where we’re much more flexible in how we think about it. When you listen to McWilliams talk about it, it’s everyday language. It’s like talking to that really great supervisor you have, and you couldn’t quite put your finger on why it was just the gestalt. You learned a lot. You were well held. You took developmental risks. I’m idealizing a bit here, but I think it’s appropriate.

So I [00:09:00] would credit Nancy McWilliams and her work creating a translating bridge to psychoanalysis with any of us in millennial generation or younger finding an interest in it as a form of practice. Analysis is also active in some of our most pressing human and political questions at this time. There’s a book called The People’s History of Psychoanalysis, by Dr. Daniel Gastón-Vildó that is a good representative text of what some of the younger folks we could say are doing in analysis.

Another important effort that has come out in recent years headed by Dr. Dorothy Holmes, the former director of my graduate program, she’s directed for many years there, also an analyst. She’s been leading a commission, which has been looking into psychoanalytic institutes where a lot of analytic training happens [00:10:00] and trying to understand the lack of representation and how to make formal analytics spaces more inclusive will be a great way to summarize it.

I could go in a ton of different directions. These are my peers and my folks. They’re doing exciting things. For the listeners here, I would say, if you haven’t given the analytic world a look recently, consider dipping your toe in. You won’t have to read Freud if you don’t want to.

Dr. Sharp: I think that’s all people want to hear probably is, is it really just Freud? No, there’s plenty more to look into.

Dr. Ben: A lot of good too.

Dr. Sharp: We’ll put all those books and links in the show notes as usual so folks can go check those things out if they would like to. I wonder if we start to bridge a little bit. To me, the perhaps obvious overlap of analysis and assessment [00:11:00] is in something like the Rorschach. You tell me if that’s maybe a good place to start and if not, we can go a different direction. I’ll leave it to you.

Dr. Ben: I think the Rorschach is a great place to start with both because it’s analytic in spirit and because it has had to negotiate some of the same changes, challenges, opportunities in a shifting profession of clinical psychology. Rorschach himself, there’s a really excellent translation of his original book that was just released, published by APA. Dr. Phil Erdberg, probably here in the area, headed that project.

It’s excellent because you see a person struggling with a tool like the Rorschach, which can be so ambiguous and expansive [00:12:00] struggling to bring some kind of structure, struggling to bring some kind of common language way of testing our hypotheses to this endeavor.

Then Rorschach, the instrument, comes to the United States in the 20th century. We’ve got all kinds of different ways of coding it and interpreting it, and this is where the Rorschach gets some of its reputation of being a bit too loose when it comes to psychometric armature. That changes when we get to Exner. He did a bunch of research, he brought some of the variables into the 20th century but the most significant shift that listeners are likely familiar with would be the R-PAS, which has gone a long way towards testing and verifying these variables.

So the Rorschach has this quantitative element. And that’s essential because it’s the reality of how we communicate and look at each other’s work in the Guild of Psychology, [00:13:00] but there’s still wiggle room for some of the close ideographic, very personal, very aesthetic, and very alive dimensions that something like the Rorschach offers.

Dr. Sharp: I like the way that you put that. It’s cool to have the history. I like that we’re peppering in some history already. I love having context and understanding where things come from. So I appreciate that. You mentioned that there’s maybe an example that we could talk about that would bring this to life a little bit, would you be willing to share that?

Dr. Ben: Sure. As it regards the Rorschach, a first way we could start to think about that would be, did you as a child or maybe now with children ever play the game where you look up at clouds, you [00:14:00] say how that looks like, and you fill in the blank?

Dr. Sharp: Oh, sure.

Dr. Ben: Can I ask what’s enjoyable about that game?

Dr. Sharp: I think that it’s so variable that you get to see where everyone’s imagination goes. You get to have some sense of how they interpret ambiguous shapes and stimuli, and maybe give some insight into mood, hopes or what they’re excited about, something like that. And it’s totally wide open. It can be whatever you want it to be.

Dr. Ben: It’s this way to get to know people that leaves room for a surprise. One way that I think about psychoanalytic work is a way of approaching our work that leaves room for the patient to surprise us. You could point at a cloud and you could say that looks like this, and a group of people might look at it and say, well, I really don’t [00:15:00] see that.

So it’s not that anything goes kind of structure, but it is ambiguous enough that we can try to make some meaning. And that is how Rorschach designed the original 10 inkblots. His father was a draftsman. He wanted to create forms; human, organic, animal, these types of things that were suggestive, but not so explicit that there was a so-called right answer.

I often use this example of watching clouds because it’s a familiar enough example to most that it usually gets us into a conversation. It’s a way of helping, for example, parents think about not only this tool that I’m saying, hey, I’d like to include in part of my work assessing your child, but also the process of assessment itself.

So in this meta way that [00:16:00] Rorschach, children are a bit like inkblots, and we as assessors are looking at these different features of the blot, we’re trying to integrate them. And there are certainly some answers that are much less supported and maybe much more concerning, but there are also many different types of answers that can be useful and helpful that can activate the types of things you’re talking about. Like I’m getting to know this person. I see what their imagination is like. I might even get a flavor of how they’re feeling today or how they organize people in their life.

Dr. Sharp: I like that. I didn’t know where you were going with this cloud example, but that totally fits. We are in many ways going through a similar process as we assess kids and try to see what’s going on with them. Kids are pretty ambiguous sometimes.

Dr. Ben: Yeah. And so is our life and our life to children who [00:17:00] are in the process of development of systems and structures that they’ll use to organize their experience. A loud classroom with lots of moving pieces, with different types of social dynamics, with physical movement happening in a lot of different directions; a lot of that is ambiguous, but it’s not random. There’s some structure in there.

And so when we’re thinking about a child who’s becoming overwhelmed and unstructured class time, we’re engaging in some of this Rorschach-like exploration of trying to get a sense of how they are navigating something that’s ambiguous but not random. And that’s part of why the Rorschach has the second phase where our job is to understand not only what they saw, [00:18:00] but why they saw it that way. Part of what we look at is their process of explaining, well, this is why the blot looks like a dot, this is why the blot looks this way, or this is what I thought was going on in class when I got overwhelmed and started shouting.

Dr. Sharp: Right. As you describe it, I see a lot of parallels between this and the Montessori model in particular, where, I don’t know how much you know about Montessori, but it’s like a rigid box, but then whatever happens within that box is pretty open. It is these classroom materials that are laid out and the kids get to choose whatever they like and work in whatever way they like for however long they like, and that’s really cool. Now I’m seeing the Rorschach everywhere, I’m seeing projectives everywhere.

Dr. Ben: Okay, good. Then this is [00:19:00] what I’m going for here, because one of the things that’s difficult about talking about psychoanalysis is there are two schools of thought. There’s analysis that is about knowing, which is like, this is how the unconscious works. I’m going to make these interpretations. So the analyst reveals to the patient some truths that they were fighting not to know.

There’s also analysis that is about being; how do we support their capacity to be in everyday life? And being, when we start to see that as our goal, we’re getting closer to what I think you’re saying when you talk about the box. In jargon speak, we might call that the container. The container’s literal things like, I’m going to meet you for 50 minutes. There’s a fee for my session. There are certain boundaries in our relationship that we do not cross. That being established, there’s a [00:20:00] whole lot of room to see what comes up and to see what a person makes of that experience.

Dr. Sharp: Right. I’m going to go completely off script and maybe ask an irrelevant question, but I do that sometimes and we’ll see where it goes.

What are your thoughts on the show Shrinking, if you’ve seen it?

Dr. Ben: Can you jog my memory about it because it’s ringing a bell, but I’m not sure I have?

Dr. Sharp: Okay. So the general premise, it revolves around this group of three psychologists who are in practice together. One of them is very prone to going wildly off script. The container is a little diffuse where he’s meeting clients in public. One of his clients ends up living with him. If you haven’t, that’s okay. We don’t have to go down this path. It’s going to talk a little bit about the interplay there of the [00:21:00] container, if it’s a little bit wobbly and what happens there.

Dr. Ben: Sure. Folks will often ask me, have I seen this? There’s the literal question; have I seen it? There’s a dimension of kindness, I want you to understand enough context so that we can look at the cloud, the inkblot together, but there’s also something people are noticing when they’re bringing it in. I hear you noticing something about container boundaries, how that gets diffused, and that that’s something that’s represented in this show.

Dr. Sharp: Yes, absolutely.

Dr. Ben: This gets us to a really important question about ethics because analysis in some ways has been, siloed might be a good way to describe it. And so there’s not [00:22:00] necessarily a whole lot of broad familiarity with how it works. And so these media examples of how analysts, how therapists who might work from that orientation work are a lot of people’s point of entry and then get us thinking about what would it be like to see that person and how odd or concerning it might be to work with a therapist who might invite me to room or so. I don’t know. That one’s verboten for me. It’s not my rule.

Dr. Sharp: No, that’s fair. I think you make a good point that analysis has in either enjoyed or not enjoyed a lot of media attention. I think of all the approaches that we do, it’s probably the most depicted in media for better or for worse.

Dr. Ben: A better example might be, have you caught Couples Therapy on Showtime?

Dr. Sharp: No, I haven’t. I know what you’re talking [00:23:00] about. I just haven’t seen it, which is ridiculous. My wife is a Master’s-Level Therapist who does a lot more depth-based spiritual work with folks. And so it’s a wonder that we haven’t seen every single therapy show out there.

Dr. Ben: I feel you, sometimes we got to not watch the thing that is so on the knowns. Orna Guralnik is excellent in it. I think a good example of the modern practice of analysis, which includes you see the analyst. The analyst is no longer just the white man behind the house. And so some of these media presentations I’m a bit more fond of, my favorite would be Dr. Melfi and his fans.

Dr. Sharp: I was going to bring that up and then I didn’t want to totally, but you’re right, that’s one of the best. That’s going to stick in my memory for a long time.

[00:24:00] We’re going down a good path here where we can start to talk about the actual application of some of these analytical tools to assessment, but I would love to dig a little bit deeper into these actual tools to set the stage before we totally make that leap into the assessment world. You mentioned the container, but I know there are many others that could be relevant in our work, and I would love to just hear about some of these concepts, tools, to provide some context for our discussion here.

Dr. Ben: Oh, certainly. So one of them I think about, and I imagine folks with therapy experience, whether present or in their training, might be familiar with the phrase, the slower you go, the faster you get there.

Dr. Sharp: Yes.

Dr. Ben: And that is, in my mind, a tenant of analytic work, meaning that [00:25:00] we have to toggle the pace down a bit. We have to get a little more Montessori about it. We have to try to remove some of the ways we typically structure things so that we can learn something new.

A place that I think this comes up very directly in assessment and in assessment practice is nowadays, I would say most kids I assess have already been assessed probably multiple times, and I think your experience too. Some of that is I don’t assess in the three to six range as much as I did in my training and early careers.

So you’re seeing teens, they’ve been assessed before. We refresh the data, that’s pretty typical, but reassessment sometimes looks like hopping between lots of different diagnoses like I went this place [00:26:00] for the ADHD assessment and then I followed on over here for the autism assessment, and I wasn’t really so sure. What about this other thing?

And so as an assessor, I might be looking at 3, 4, 5 different reports. They can all create reports, they can give depthful data-based insights into a part of this child, but when we scale back to look at the whole system, we might be noticing something like a process of intensification, positive feedback, where on the surface we’re talking about assessments and figuring things out, but underneath there’s some kind of fear, some kind of reactivity, some kind of acceleration that is also part of this process of getting multiple assessments and layering them on.

In some cases, that can be a bit more concerning than others [00:27:00] because sometimes when you’re looking at lots of different parts of the elephant, you might be missing a rather important elephant. I know I’m getting a little wordy with my symbols, but so the first piece I would think about is this sense of slowing down, particularly when we’re looking at multiple assessments.

It doesn’t mean disregarding them at all. It means adding to them by wondering what else is happening in the context and the ecology of this child and this family. Does any of that help me understand the history and the journey of assessment that they’ve had so far?

Dr. Sharp: Yeah, that’s fair. So you’re talking about asking big picture questions or even just observing and taking in the environment, the context, family dynamics, everything that’s gone into this kid’s history up to that point and putting the current assessment in context with all those factors. Is that fair?

[00:28:00] Dr. Ben: Absolutely. I might add to that, Stephanie Nelson uses this phrase that the secret question, and I’m very fond of that idea for two reasons:

1. It’s a question and questions are so helpful in our process.

2. It’s a secret. And that implies it might even be a secret to the family themselves.

So part of what we’re trying to do is we’re trying to create a space where we can support people to put into words what the analyst Christopher Bullis calls the unthought no. So, as feeling this fear that you might carry around as a parent about your child that is partially explained by diagnosis, but there’s more residue there. There’s more depth, there’s more feeling that you’re holding on to, but you couldn’t put it into a question to an assessor because [00:29:00] it’s just that deep, or it just hasn’t had that process to come into worth yet.

I think that’s a very important space and opportunity for us as assessors, and one that you need not be an analyst to have skills to go into, though I think analysis does offer some interesting thought frameworks and keywords like the container to help us bring some language examples.

Dr. Sharp: I like that. I like to get concrete with things. So what does this look like in the assessment process? I was running through my mind, what if I just ask parents their deepest fear as they come into the evaluation, maybe that’s a little too intense, but I tend to live in extremes. So I’d love to hear how you tackle that.

[00:30:00] Dr. Ben: You have figured me out that I pull a lot of history into how I think about things. I think what you’re getting at here, how do I go about this? Could I, for example, just ask a parent, what’s your biggest fear? What kind of question does that feel like? Is that too close, too intimate, too much? Am I going to overwhelm them?

Without going into the whole history; one of the biggest fights in psychoanalysis was between Anna Freud, Sigmund Freud’s daughter and Melanie Klein, for who was going to inherit the field. Melanie Klein, who I’m probably more aligned with, was of the opinion that if someone is really anxious and frightened, naming that or inviting that into words can be profoundly rounding.

I think a place that this comes up for me, that’s more concrete is [00:31:00] those cases where I start to wonder, are we looking at some prodromal functioning? Are we looking at the possibility of some incipient psychosis in an adolescent? Because that’s a very low base rate thing. We’re usually not reaching for that as our first interpretation of the data in front of us. There are a lot of other higher base rate things we want to evaluate first.

And yeah, most folks going for an assessment don’t understand what psychotic process is, wouldn’t imagine to think to look in how that might be showing up in a child’s development, and wouldn’t necessarily have a place to go to get that assessment question answered. I think when this question comes up, it’s often some deep fear a parent had, and it might be like, who is my kid? How do I understand them? How will other [00:32:00] people understand them, and will they understand them in a way that’s going to support them having a good enough life?

So, my long-winded way, Jeremy, is I trust that you could contain the response if you ask the question. I’m curious how it goes in a case, if you find yourself asking.

Dr. Sharp: Sure. I’m trying to think if I’ve ever actually asked that question. I would say that I do ask a version of that question in most intakes or interviews. Typically, it comes toward the end after I’ve built a lot of rapport, hopefully, with the family and can dive in and just say some version of, this is a scary process. I wonder if you’re worried about X, Y, or Z.

Sometimes I’ll name what I think might be a fear of theirs, and I’ll generalize it and just say, hey, most [00:33:00] parents almost always come in thinking that I’m going to tell them they’re the worst parent in the world, so if that’s running through your mind, that’s totally okay, or that it’s somehow your fault. I’ll get at it in some kind of different way. And then typically, I would say, way more often than not, parents will breathe a little bit and acknowledge that that’s part of the picture for them. And then we’re aligned and it’s out in the open.

Dr. Ben: I hear that that’s a process for you. That it’s not the first thing you’re going to ask, and perhaps because that gives you and them a chance to build an alliance, that gives you as an assessor a chance to understand how to engage with them on this question, their readiness for it. I don’t mean readiness like are they strong enough or good enough as parents, I mean in some stages in life, we might have so much [00:34:00] happening and it’s so overwhelming that getting to that level 3 question, to use a TCA term, might not be a first session endeavor. Another thing I hear you doing that I could build some analytic bridge to is diffusing the punitive superego.

Dr. Sharp: Ooh, what’s that? Let me guess.

Dr. Ben: You speak to a parent’s unconscious fantasy that you were there to punish them. That we’re going to identify with the superego, they project. Projection’s not so bad in modern psychoanalysis. It’s how we communicate, but you’re sensitive to that being a parental experience, maybe it’s something you can identify with, maybe you’ve just worked with so many parents, you know like I know that that’s one of the hard parts of being a parent is you’re so in it, you want to know that you’re doing it well, and it’s very vulnerable to go to an assessment, for example, and get some [00:35:00] information.

So I hear you naming the possibility of that projection and just diffusing it, turning the heat down on that. And that, I guess or I would imagine in many cases gives you more room and emotional safety to get to those deep fears.

Dr. Sharp: That’s the hope. Great.

Dr. Ben: That’s what we got is hope and reflection, right?

Dr. Sharp: Yeah, it’s true. Okay. Nice. I like this. We’re slowing the process down, what other tools are out there that we might pull from the analytic world?

Dr. Ben: Sure. So another that I would think about is attending to negative space. By negative space, I’m using this in the artistic sense because we all took the EPPP and I feel pretty certain this [00:36:00] was in a study guide somewhere. You remember those gestalt images, is it two people kissing or is it a vase?

Dr. Sharp: Of course.

Dr. Ben: Of course, that’s playing on this idea of positive and negative space, foreground and background. And in psychoanalysis or a psychoanalytic approach, we’re doing work to make sure that we’re thinking about the negative space because it’s so easy to get caught up in the foreground. Oh my gosh, this school year is really rough. The teacher is not a good fit with my kid. Friendships have blown out. It’s one of those types of things that might bring a person to assessment.

We want to listen to all of that and take it very seriously because it’s top of mind. It’s why someone’s coming in. So there’s more that we can add to that. There’s more in this space in between. And to try to make it [00:37:00] practical, this connects with slowing down. There’s the early assessment process before someone has even signed an agreement and formally engaged the assessment.

And so in my practice, we think a lot about what is happening in that initial phone call. What is happening in that initial message? We’re not just listening for scope of practice and potential questions, we’re trying to better understand the context of a parent, of a child, of a family because something about that context will help us to create a fuller texture in the same way that you need the white space on the Rorschach blots for the inkblots to appear for them to be right there.

Dr. Sharp: I like this. And so how does that show up? Again, just bringing it to life, [00:38:00] can you give me examples of what that looks like figuratively when we’re paying attention to the negative space even in the phone call or even in the interview or during the assessment process?

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All right, let’s get back to the podcast.

[00:40:00] Dr. Ben: Sure. This is what I think about because it’s one I’m vulnerable to falling into. I call it the 3-minute voicemail or the multiple voicemail, where you get a voicemail and it runs out the time on your voicemail, and then you get another voicemail after that. This raises a lot of questions for, okay, what is happening here? What can I already begin to get curious about?

I might pull for some other information too, like how am I feeling when I listened to this? Because, for me, I’ve noticed that a countertransferential process I really need to pay attention to is if I listen to a voicemail and I have the immediate urge to call the person mad, even in some totally unrealistic way, like I’ve got a session in 10 minutes. That’s not going to occur, [00:41:00] but if I feel that urge, if I start to imagine like I’m coming to the rescue, but I have no idea what that would be or what it looks like, this helps me to think about this case in a different way.

For example, this might not be the kind of case where I ask the parent, what’s your greatest fear about their child because they may be in a state of too much happening in the system, too much flux and flow for that question to be helpful, it might just be overwhelming and disorganizing. So we have our checklist of things we go through in these business processes, like, oh, it’s a new call. What’s the question? What’s our availability? When do they need it?

We’re doing this intake in triage process, but I guess what I’m trying to emphasize is there’s already clinical material in those initial moment, and we shouldn’t [00:42:00] jump to conclusions really heavy handed interpretations, but if we listen to that information, if we start to get curious about it, it opens up a whole other channel of observations.

Dr. Sharp: Okay. I like where we’re headed with this. Yes. Okay. So what’s next? We’ve got the negative space; do we have more tools that we can work with?

Dr. Ben: Sure. So another is, oh gosh, I’ll ask you because you mentioned this when we had our first conversation. Would you be willing to share your experience about Beyond?

Dr. Sharp: Oh, yeah, I will. I don’t know that it’s going to live up to the hype here, but I will share my experience there. Yes. So to provide some context, I think I told you in our initial call that [00:43:00] my wife and I, who I mentioned already is a therapist and she’s a group therapist specifically, she specializes in group work.

I’m sure this guy beyond is a pretty powerful figure in the group space. I don’t know much about him. I’ve only had this ancillary contact. And so we went to the American Group Psychotherapy Association conference. This was 15 or 17 years ago. We were not married yet, but we were engaged.

And so we get into this workshop. Just a disclaimer for anyone out there who wants to go to the AGPA conference, any workshop will turn into a therapy group. The boundaries are diffuse. The container is pretty diffuse at this conference. So [00:44:00] we didn’t know this. This was our first time. We’re young. We’ve just graduated.

And so we go to this conference and we end up in this workshop together, and it turns into a therapy group. And so we are in this group with maybe 15 or 17 other people. Halfway through the group, somehow we disclose that we’re engaged and together. And the group at that point, and it was based on Beyond’s approach to group work. That’s how he comes into this story. Our group leader referenced his approach several times.

So we disclosed that we’re together, we’re engaged. Somehow that comes up and immediately the group turns on us and we become the scapegoats for the group because we’ve snuck into the workshop and we are an energy system that is more aligned with one another than to the group and people [00:45:00] went nuts. We were deer in the headlights, what the hell is happening right now, and why aren’t we learning about the thing we wanted to learn about?

Anyway, that’s the story and it ended up pretty poorly. We ran out of that conference and we’ve never gone back. That’s my experience and my brush with Beyond and his group.

Dr. Ben: Thanks for being open to share that because I’m guessing you haven’t picked up any Beyond sense.

Dr. Sharp: When we got back home, I did dig into it a little bit and read through some of the theory and the work, but it’s been a long time.

Dr. Ben: Okay. I wonder how many of these types of experiences listeners have had in some kind of relationship with psychoanalysis, and the experiences, because I’m familiar with his work, I imagine where they’re going is, [00:46:00] you and your then fiancé, you were a primal scene. You were like the parents in the Oedipal scenario. You represent some kind of knowledge or alliance that they’re necessarily excluded from, and then the manner of primary process breaks.

Dr. Sharp: That’s great. That’s probably why.

Dr. Ben: It makes me curious about the container in this experience of yours. Your face says it all. Because if there’s a container, we can go into that. We can fall apart. We can see just how charged and powerful feelings can be in groups. The other part of Beyond is he uses this word metabolites. The analyst, the parent, the assessor, part of what we have to do is take in what the patient or the group or the child, whoever we’re working with is throwing [00:47:00] at us and digest it a bit and give it back to them, and that they can take it.

Dr. Ben: That makes sense. I like that word. I think we do that quite a bit. Yes.

Dr. Ben: Yeah. I think a lot of it is naming stuff that is probably already part of people’s practice. There just isn’t an analytic jargon attached to it and there need not be. I brought in that piece about Beyond because he has this phrase where he says every session should begin without memory or design.

Of course he’s talking about analytic or therapy sessions and on the one hand, that sounds less might be a reaction it would have because it’s like, what do you mean without memory and desire? [00:48:00] I’m supposed to be tracking the course of treatment and if I don’t desire to help this person in some way, well, then why am I here?

But he’s offering it not in such a literal way, but as a meditation to say, can you start to notice the frameworks that you bring into a space? The heuristics that you use to understand what is happening in front of you. Is there a way to set them aside a bit so that this person can reveal themselves to you, so that they can show themselves to you?

An on-the-ground example would be a classroom observation. So do you use a structured form for your classroom observation or do you go in there and observe? The latter might sound [00:49:00] foolhardy like, well, it’s no structure but I think there are appropriate ways to approach that kind of encounter.

The fact that there isn’t such a clear structure gives you more of an ethical imperative, gives you a certain kind of responsibility you have to enter it with, but it might reveal something that might fall through the cracks or sit there in these between spaces on a more formal observation measure.

So another way we can look at this is when we’re wondering about lower base rate presentation. Like I mentioned, from trouble concerns, because that’s something that comes into my practice once or twice a year. If we go in and we’re using our high base rate conditions and explanations as our default, we’re more likely to miss those lower base rate possibilities.

[00:50:00] And so a more concrete application of this in the assessment world would be something like, hey, also keep the low base rate things in mind because base rates have a certain truth to them, but just add or notice ways that in the busyness of life, we might be filtering important information now.

Dr. Sharp: Got you. Would this also apply to confirmation bias at all, and how that comes into our work?

Dr. Ben: Yeah. Tell me about the leap you’re making.

Dr. Sharp: I’m making this leap of faith, we suspend these initial expectations and we try to come in, like you said, without memory or desire. And to me, that just seems like a natural antidote to confirmation bias where we’re entering an assessment just based on, let’s say, the parent says that they’re coming for an ADHD assessment. It’s hard to not go into the testing thinking I’m ruling out everything but ADHD, I’m ruling in [00:51:00] ADHD or whatever, we’re confirming that initial theory, whereas if we come in with a little bit more of a blank slate, so to speak, then it helps combat.

Dr. Ben: Yes. I think the idea of confirmation bias and I know cognitive biases is a returning topic on this podcast. It’s a set of episodes I always drop into. I do think you’re making an important and accurate leap there. So this phrase that could sound foolhardy, arrogant to analyst actually has a close relationship with a scientific process of observation.

Dr. Sharp: Great. I’ll take that. I’m not sure if it’s exactly what we’re talking about here, but you bring up the topic of autism and how this may fit in with some of [00:52:00] these ideas. I definitely want to talk about that because I feel like it’s a fraught topic right now, an area that a lot of us struggle with. So what are you thinking in that regard?

Dr. Ben: I can go in so many directions here, so I’ll rely on you to help keep our conversation tethered because this is the focus of the book that I’m working on, which will be titled, Farewell Diagnosis. It’s under contract with Bloomsbury. So what happens when I say the title? What comes up for you?

Dr. Sharp: Oh, gosh, I was 75% thrilled at this idea and 25% what’s going to happen to my life without diagnosis. Like I said, Ben, I live in extremes. I am who I am, but that’s what happened. I was mainly excited about this. I love the [00:53:00] title.

Dr. Ben: Okay. So looking at negative space, looking at the quieter sound, looking at the smaller proportion, could you tell me about the 25%?

Dr. Sharp: Yeah. So this comes up, I think this is hot on the heels too, because I just recorded an episode with Stephanie Nelson about, we call it evaluations 2.0, where we’re looking beyond diagnosis, strengths, challenges, recommendations, and bigger, deeper topics. I joked to Stephanie, this always comes up when I talk to her, and it’s this question of what am I going to do with my life?

Because every time I talk to her, I feel like she blows the doors off of the traditional assessment model in some form or fashion. And then I have to recalibrate and think, okay, how’s this going to affect my practice? Are we going to stop diagnosing? And if so, what does that mean? And can I learn something new? Is it too [00:54:00] late? Can I do it well? It triggers this cascade of questions and feelings around the foundation. It shakes the foundation of the work that we’re doing.

Dr. Ben: Absolutely. I can relate to those feelings. I imagine many listeners can. I think something that comes out of the self-diagnostic movement is an awareness of diagnosis, especially with something like autism. I don’t want to imply that there is no objectivity to it, certainly, but that objectivity, the idea that it represents something very true and we can know what that is seems very much in flux.

Dr. Sharp: Yes.

Dr. Ben: I think for two reasons, because we want to talk about two points of history, [00:55:00] one’s related to identity, one’s related to assessment. I’m a queer man and I’ve worked with queer folks and trans folks all of my training and career, et cetera. And so I’m very familiar with the history of how our identities became diagnosed.

Dr. Sharp: Yes.

Dr. Ben: Homosexuality was removed from the DSM and it’s no coincidence that it was replaced with gender identity disorder. The thought being, oh, that was a way to keep conversion therapy approved by insurance companies, feminine boy project, all this sort of thing.

So that makes me sensitive to some of what’s happening almost in a mirrored way, where it isn’t the identity becomes a diagnosis per se, it’s that the diagnosis is now becoming more of an identity. And then this leaves us in a really interesting place as assessors because we used to hold that [00:56:00] symbol. That was our symbol, it was our job, it was our license, it was our responsibility.

I’m saying was like it’s past tense. It’s not, this is still very present and real. And so there’s a way that our identity is wrapped up in it too. And so when we’re meeting with someone who might be self-diagnosing or in a process of self-exploration, it seems like everyone at the table has some deep personal investment in it beyond just doing their job.

Another piece of history that I keep in mind when I’m having feelings like the 25% you mentioned, oh my gosh, will I have a job is there’s a book called the Assessment of Men and documentation of this team of psychologists that was gathered to create the assessment process for the then office of special [00:57:00] services, now the CIA. It’s looking at how do we create a battery to see who’s going to be a good spy?

Nevitt Sanford, who is the founder of the Wright Institute, a place probably many listeners know, large alumni base there was one such psychologist. So he’s listed in the name of people. If you look at the names, it’s a lot of really big names in psychology, you might’ve known from your licensing exam or because they’re part of your tradition.

I used to assign the first chapter of this when I would teach assessment, because even though it’s written almost 100 years ago, they’re dealing with the same questions, problems, dilemmas, how do we respect the individuality of the person and the diversity of human experience while also trying to bring some kind of non-methodic reasoning, some kind of structure and organization to what we’re doing.

[00:58:00] Those things are all very alive, and we have a pretty deep emotional connection to that beyond just what is the research saying? What’s the truth?

Dr. Sharp: Sure. There’s a lot to unpack here. I just want to go back to that. The point that you make about the diagnosis becoming the identity and then that taking some “power” out of clinicians’ hands and that being threatening resonates. I don’t know exactly where to go with that, but I’m just recognizing that stirs something. I think that’s important. I would imagine a lot of clinicians feel similarly.

I’m just imagining too, you may know more than I do or thought about this in a deeper way, but [00:59:00] folks, let’s just take the self-diagnostic movement or the autistic folks who are self-diagnosing are probably like, yeah, it’s about time the power balance shifts a little bit. I’m just thinking out loud and processing through that that’s a big shift and a real process for folks.

Dr. Ben: Yeah. It’s about time thing calls to mind the decades of history and activism around this. Judy Singer writes her master’s thesis that features the word neurodiversity in the early 90s. Of course, there is a movement around that that she also acknowledges at [01:00:00] that point.

I think when we’re doctors or in my experience, when you’re going through training, if you’re in a place that’s fairly well supported, part of my training was at the Reginald Lourie Center. So very much in like the attachment in child psychodynamic and Head Start moving inside of things. It was really great training.

It gives you this impression of what’s possible when the system is working well, but this system often doesn’t work very well. And some of that is dynamics of historical oppression. Some of that is something like COVID. The question I like to ask assessors is, how did COVID change assessment? And the reason I like asking that is because everyone’s got thoughts and ideas, not only general, but also very specific.

[01:01:00] I was working in this setting where I was trying to place where, and thinking about that specificity helps us to appreciate both what folks in the self-diagnostic movement are calling the field to think about, but also some of our own response. What do I mean by that?

If you can appreciate how hard it is to obtain a comprehensive assessment in this country, then I think you can appreciate how valuable a process of self and community exploration for a person struggling to access assessment might be. I’ll flip it a little bit, and I’ll join you in some of the vulnerability or some of the ways that the doctor feels, I guess I’ll call them.

My shoulders come up, I’m irritated and I’m agitated about the issue. This tends to happen when something else is [01:02:00] also happening. What do I mean by that? An assessment comes in and the question is, well, is it autism, or we think it’s autism, and I might be noticing, um, significant trauma, a major medical event, a terminal illness, and a primary attachment figure, um, an affair or infidelity between partners that does not seem to have been reckoned with or processed.

When those things are in the texture. I sometimes worry that diagnosis gets so loaded with hopes, fears, and desires that we’ll miss these other things that I, as an assessor, see as important. And it took me a long time to get to this position because I think it can sound like saying, I’ll join you in some extremes, in the extreme, it could sound like saying [01:03:00] you can’t be autistic because you had trauma or you can’t be autistic because there’s emotional over involvement in the family system.

That’s not at all what I’m saying, I hope because I don’t believe that form of practice. And yet we are faced with this dilemma of how do we engage folks? It’s the dilemma we’ve always had. How do we talk to them in a way that recognizes the reality of their experience while introducing something of our own, and have it end in a way that’s better than the group conference experience you mentioned?

Because that’s the risk is we come in with jargon and our power and these sorts of things. We flame it down there and people are like, I don’t know what any of this means. And you don’t understand me. I think that’s a big part of the dilemma that we’re negotiating. Part of why I gave the book this title, Farewell [01:04:00] Diagnosis is I’m wanting to explore what happens when we exceed diagnosis. What do we add to it? When we get curious about not just whether I have certain sensory differences, executive functioning differences, social communication differences, that big DOS triangle, but what would it mean for me to be autistic? What would it mean to this parent if the child is autistic? What do they hope will happen if that diagnosis is verified? Is it understanding? Is it patients? Is it higher self-esteem?

And whatever those hopes are, how will the diagnosis get us there? Because I think there’s a way that right now the diagnosis feels a bit almost like a bubble, and I don’t want it to pop. And so I’m trying to play with, see, [01:05:00] think about, engage in dialogues like this to see, can we bring more of this negative space around the diagnosis and will that help us to work through what could easily be a standoff between profession and pay?

Dr. Sharp: Well said. I would love to hear more about this, and it sounds like you’re writing a book about it, so that’s good. Tell us, I know the time flew during this conversation and I know there’s so much that we didn’t even get to, and we could talk for a long time about this, but I do want to hear how this dovetails with the writing that you’re doing and what’s going on with this book?

Dr. Ben: Sure. So the book came out of, I wrote a [01:06:00] chapter in an edited volume. It’s called Precarities of 21st Century Childhood, looking at childhood in a psychoanalytic lens, and some of the things that are missed and left out and how we commonly talk about it. My chapter was called Fractional Distillation: On Psychoanalysis’s (Mis)Formulation of Autism. Because some of the older analytic literature approaches autism as the most base preedible condition that needs to be cured. They talk about children being cured of their autism. There’s some really intense problematic ways they engage this.

What I was trying to do is say there’s still something that we can learn. Fractional distillation comes from the idea of a fracking column. Roughly speaking, the fracking [01:07:00] column is we’re heating a bunch of crude and we’re putting it under pressure and the molecules that come out at the top happened to be the more valuable ones, rocket fuel and diesel and the ones that come out the bottom, that’s the stuff we’re going to use for asphalt.

And so I was trying to use this metaphor as a way to explore the danger of making therapy something that makes an autistic person or attempts to make an autistic person not autistic. And so in the advocacy community, we might call that masking. So I was trying to open this conversation about how forced masking to get someone to a higher level, to make them more productive or spur along development in some way potentially carries a cost.

The chapter was warmly received by some folks. An editor approached me and said, “Hey, would you make this a book?” So that’s what [01:08:00] I’m doing. And the way I’m trying to approach it is, are you familiar with The Double Slit Experiment?

Dr. Sharp: No.

Dr. Ben: Back in chemistry, someday was probably exposed to us, at least that’s where I heard it. It’s this quantum theory or the series of experiments that revealed to us that light behaves both as a particle and a wave. Depending on how you arrange the measuring apparatus, you’re going to see something different. And so in our world, that could be depending on the type of battery, or the meaning making system of the assessor, you may or may not see autism.

And so I use that as a metaphor to look at this relationship between self-diagnosis and clinical diagnosis, and how they’re entangled with each other. My hope is that the book fosters a [01:09:00] non-binary dialogue. Because I think the thing that feels most unfortunate about this conversation nowadays is when it just becomes a split; there’s no engagement or exchange in between. So the book, the shortest way I can put it as an attempt to try to do some of that exchange.

Dr. Sharp: I love that. What’s the timeline? When can we get our hands on this book?

Dr. Ben: Oh gosh. My first draft will be submitted for peer review in August, so I’m guessing sometime at 2026. I run a group practice. I’m not an academic. So writing is what happens in my evening and weekends.

Dr. Sharp: I know that very well. So what I take that to mean that we’ll just have to commit to having another conversation on the podcast at some point in the meantime to dig deeper because I don’t know if I can wait that long. This has been a [01:10:00] really compelling, thought-provoking discussion. I have a lot of admiration for how you’re approaching this topic and clearly thinking pretty deeply about it. So I would love to have some further discussion if you’re up for it at some point.

Dr. Ben: I absolutely would be, Jeremy. I want to express my appreciation for your openness to this. Being someone who works psychoanalytically and someone who’s also an assessor can feel like a very split experience, because assessment space doesn’t often encounter psychoanalysis, and psychoanalytic space doesn’t often encounter assessment. So being able to engage in this kind of dialogue about it with a colleague is both rewarding in its own right and its own corrective experience.

Dr. Sharp: I appreciate that. [01:11:00] I love a good and corrective experience. That’s for sure. Oh, and I will say this maybe to tie it up a little bit that, I don’t mean this in any minimizing way, but the concepts that you’re talking about feel familiar. The language and the terminology may be different as it is, in many of our theoretical orientations, we’re talking about similar concepts and just calling them different things.

So the terminology is not quite as familiar, but the ideas do feel familiar. And that is comforting that it’s not as scary or as foreign as I might have thought when we started this conversation that many of these concepts and ideas, we can easily bring these things into assessment and there’s not as much distance as it seems on the surface.

Dr. Ben: I’m glad we could do some work to close that distance because I’ll link back to McWilliams. It’s [01:12:00] one of the things I look up to and her capacity to write about rigorous theory, and these ways that people read and go, oh, I already had that in the back of my mind. I needed to be in a good conversation to really appreciate it.

Dr. Sharp: I like that. Well, thank you again. Hopefully, our paths will cross again before too long.

Dr. Ben: That sounds good, Jeremy.

Dr. Sharp: All right, y’all. Thank you so much for tuning into this episode. Always grateful to have you here. I hope that you take away some information that you can implement in your practice and in your life. Any resources that we mentioned during the episode will be listed in the show notes so make sure to check those out.

If you like what you hear on the podcast, I would be so grateful if you left a review on iTunes or Spotify or wherever you listen to your podcasts.

And if you’re a practice owner or aspiring practice owner, I’d invite you to check out The Testing Psychologist mastermind groups. [01:13:00] I have mastermind groups at every stage of practice development; beginner, intermediate, and advanced. We have homework, we have accountability, we have support, we have resources. These groups are amazing. We do a lot of work and a lot of connecting. If that sounds interesting to you, you can check out the details at thetestingpsychologist.com/consulting. You can sign up for a pre-group phone call and we will chat and figure out if a group could be a good fit for you. Thanks so much.

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[00:00:00] Dr. Sharp: Hello, everyone. Welcome to The Testing Psychologist podcast. I’m your host, Dr. Jeremy Sharp, licensed psychologist, group practice owner, and private practice coach.

Many of y’all know that I have been using TherapyNotes as our practice EHR for over 10 years now. I’ve looked at others and I just keep coming back to TherapyNotes because they do it all. If you’re interested in an EHR for your practice, you can get two free months of TherapyNotes by going to thetestingpsychologist.com/therapynotes and enter the code “testing”.

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Hey, everybody. Welcome back to the podcast. Today is a business [00:01:00] episode. We’re going to be diving into a trend that many private practice owners are noticing. The trend is that client inquiries are staying steady, but conversion rates are dropping, especially for private pay practices. If you have been feeling this shift in your practice, you are not alone.

I was talking with some individual consulting clients and my cohort from the 2024 Crafted Practice Retreat and this has come up a number of times among practice owners. So what is driving this downturn? And more importantly, what can we do about it?

In this episode, I’ll break down the possible reasons behind the trend from economic factors to pricing models, and share some strategies to help you boost conversions and communicate the value of testing more effectively. Whether you are an established practice owner or just getting started, this discussion will give you some practical tools to navigate [00:02:00] this potentially changing landscape and book those clients.

So speaking of this business discussion, if this is something you’re wrestling with and you want to talk in a little more detail about this or any other business management topics, you can check out thetestingpsychologist.com/consulting. I am doing strategy sessions now, which are one-off hours where we dive in and try to solve a problem or two, and send you on your way with some practical real solutions to move forward. If you’d like some help, you can go to thetestingpsychologist.com/consulting and book a strategy session right there.

But for now, let’s tackle this problem of decreased conversion rates.

[00:03:00] All right, everybody. Welcome back. We are here. We are talking about this problem or trend of what seems to be happening in different parts of the country, especially with private-pay practice owners. And the trend is that inquiries for services seem to be steady, but conversion or booking for these services seems to be declining. So I wanted to first dive into possible reasons for these declining conversion rates.

Right off the bat, I think about economic factors that might be at play. So we are coming out of 2, 3-year period of inflation. So related to that, there’s been an increased cost of living, and financial uncertainty has certainly been at play among a lot of folks. Likely this makes [00:04:00] potential clients hesitant to commit to out-of-pocket expenses, especially big out-of-pocket expenses.

There is some data, the numbers are escaping me right at this moment but I remember listening to some podcasts, at least a year ago, talking about how the COVID relief money that all of us receives is running out. So for those folks who saved it or otherwise were able to bank some money during COVID for whatever reason, that money is running out for folks and has likely run out by this point. So that coupled with increased cost of living and uncertainty, an election year is historically very uncertain time financially, and folks are less likely to spend money on big purchases during election years.

We had that going on in the fall. All that leads to clients may be prioritizing [00:05:00] essential expenses over psychological testing, which is unfortunate to see testing as an unessential expense, especially for kids, but also for adults. I think the reality is that that’s how people are viewing it at this point.

Another factor is that given the economic pressure, uncertainty, and higher cost of living in a lot of parts of the country, the natural tendency is that a lot of clients are seeking services from in-network or lower-cost providers, or like I said, just putting it off entirely especially for kids potentially pursuing services at schools.

Another factor that’s operating in the background that may not be playing a huge role but is certainly floating around out there is the possibility that these quick diagnosis options that you’ve seen [00:06:00] online, especially for ADHD, but it’s growing in popularity for autism as well, these businesses may be stealing a little bit of the market share as well.

One thing, economic factors. Another thing though, is potentially increased competition. So this is related to that last point that I just made, but more private practices are possibly offering similar services, and that makes it a little tougher to stand out for those of us who’ve been around for a long time. The group that I am seeing the most struggle with are well-established private practices who “never had to market before,” and all of a sudden, the conversion ratios are declining.

And so part of that may be that there is just more competition and that more folks are going into private practice. They’re less willing to [00:07:00] take agency jobs, hospital jobs or whatever it may be, which may be related to another economic factor, that’s assessment is not the most lucrative service line in an agency, and it might be being eliminated from some of those agency or entity positions, which forces more people into private practice.

So that may be something to think about if you look around your area and see some newer practices or more folks going into private practice, we may just have higher competition. And that means you have to stand out, which ties into the third factor, which is weak differentiation.

Let me step back. We went through a rebranding process about 6 months ago. A big part of that is to make sure that we are standing out in an increasingly competitive market. So up to this point, many practices are not [00:08:00] necessarily effectively standing out either with their branding, with their messaging, or with their services.

I saw this firsthand when we were going through our rebrand, part of the process was my branding consultant did a lot of research into our competitors in the area; the local metropolitan area, our specific city that we’re in, but also the broader geographic area. There was one point in the branding process when he put all of the logos and practice names up on a slide for me to look at, and it was startling.

Even though I knew in the back of my mind, it was startling to see it all in one place how many practices have some variation on a brain logo. They’re usually blue or green. The practice name is something [00:09:00] assessment services, or neurodevelopmental something, or brain something. It’s very hard to differentiate and stand out in this market. I think that’s starting to hurt some of us.

The other part of that in differentiating your services is that clients may not understand the benefits of private-pay versus insurance-based services. And so we’ll talk more in a little bit about how to emphasize those benefits.

The fourth factor, though, is perhaps lying in your website. We’re going to talk about this, but your website may not be optimized for conversions. So are there clear calls to action? Is it loading quickly? Is there too much friction in the booking process? There’s also a copy factor; what does your messaging say [00:10:00] on your website? Does it align with your client’s pain points?

And then another factor here is the lack of compelling content, honestly, demonstrating expertise and value in testing. So the website is a part of this. That’s a factor to even get people to call in the first place but also, people are going to do a lot of research before they call you. And if your website is not working for you, then that can be a detriment.

Another factor though, is perhaps sales and pricing issues. What does this mean? There is the basic sense that pricing might be perceived as too high without the accompanying value for that service. It could also be that we are not doing a good job in selling our product. And this feels weird, especially for practices like my own, where you haven’t had to do much marketing and the clients just come to you, to [00:11:00] view booking clients as a traditional sales process can feel very foreign.

We’re going to talk about some strategies to combat that and develop a little bit of a different script, but what I mean by sales concerns is that there may be, for instance, a lack of urgency in following up when potential clients inquire. You may not be checking back in with them immediately after the call if they don’t say yes right away, for example, or nurturing the client through the booking process or the sales process.

Another factor is that clients just might, going back to price, experience a sticker shock if your fees are not framed properly. We’ll discuss what that means. And then lastly, just another factor I was thinking about with all this is that clients are just feeling hesitant right now. They may be uncertain about the financial commitment. They may not totally understand how an [00:12:00] assessment can help with their specific issues.

It’s a big commitment, especially for those of you in metropolitan areas charging $3,000, $4000, $5000, $8000, $9,000 for your evaluations. This is a big investment for folks and they have to have some sense of trust and comfort during that booking stage to take the leap.

So lots of different factors that might be contributing to these declining conversion rates. You can think about your specific geographic area in your practice and see which one of those resonate with you. My guess is you were listening and two or three of those probably hit you a little harder than the others. And that’s probably a good indicator of the factors that make the most difference and that you might want to pay the most attention to.

All right, so what do we do? You know that I like concrete strategies and making things practical. So what are some things [00:13:00] that you could do to improve the conversions for your testing?

Let’s start with the website. A big part of this might include optimizing your website for conversions. What does that mean? There are a lot of factors. First one, make sure that the scheduling process is completely seamless. I really like this word friction or this concept of friction in the client experience, and any friction that we have introduced into the booking process is something that needs to go away.

So if you think about when Amazon introduced that buy now button on the product page, conversions went way up. It’s the same process for us. You don’t want clients to have to take a bunch of steps, click a bunch of buttons, do a ton of information before they’re able to book a call, even if it’s just a consult call. [00:14:00] So whatever you can do to make that as seamless as possible is great.

Personally, I am a fan of just having them submit a form rather than making a phone call to you. I think for a lot of people, phone calls are very friction-filled, and there are any number of reasons not to make a phone call. So if you could do an online form or even a text inquiry using a bot or something like Wendy, that could be super helpful.

What else can go on your website? I’m a big fan of video. So if you can record a video and put it on one of your booking pages or your service pages to build some rapport before that first call, I think that makes a lot of sense. You could even do two videos or a combined video where it’s you as the practice owner with your intake coordinator or whoever’s answering the phone, you’re making those calls. Video [00:15:00] goes a long way.

What else can you do? You can have clear pricing transparency with an explanation of value. I’ll talk more about how to do that in just a second, but pricing transparency. I’ve done podcast episodes on this in the past and how people value transparency in pricing. So whatever you can do, just put your prices on the website. And then you’ll have to do a little bit of work to frame the pricing appropriately, but it can be done. I think it goes a long way.

Another factor with the website is using client-centered language. So instead of saying something like our services, it’s how we can help you. It’s just a slight tweak to your language to speak directly to the client and take the focus off of you as a practitioner or the practice and make it actionable and oriented toward the client.

Let’s move on to talk about [00:16:00] messaging a little bit. I’ve talked about this in a lot of my consulting sessions. We need to adjust our messaging as much as we can to emphasize value and outcomes instead of process. One of the components here is that you want to clearly communicate the unique benefits of private pay, if you’re a private-pay practice.

Those of us who do it know this means there are no insurance restrictions, it’s more personalized care, perhaps higher confidentiality because you’re not sharing any information with insurance panels. So communicating those benefits very clearly can be super helpful.

You can also use case studies or testimonials. I just did an episode two weeks ago around reviews and testimonials, and how to solicit them ethically. If you didn’t check that out, definitely go listen to it. You can use those case studies or testimonials and put them on your website to highlight transformation stories essentially and how the [00:17:00] testing process can help clients.

Then the last component is maybe shifting the focus from the cost of the evaluation to “return on investment.” What do I mean by that? I’m sure you’re saying, okay, this sounds like one of those cheesy sales tactics or whatever, but it’s a cheesy tactic because it works. It’s rooted in psychology.

What does this mean? This would mean framing it in something like, “Investing in an assessment now can save you years of struggle down the road.” So framing it as an investment versus just an outlay of cost.

Let’s talk about cost in a little bit more detail on how we might adjust our pricing presentation to reduce the sticker shock. Cost is often a main objection of folks. [00:18:00] So the way that pricing is presented can make a big difference.

Here are a few things to consider. You could frame the pricing in terms of long term value. So instead of saying, our testing costs $2,500, you could say, for less than what you’d spend on a year of tutoring or therapy, you’ll get a roadmap that can shape your child’s life over the next several years. Something like that. So then you’re emphasizing that a comprehensive evaluation saves money in the long run and avoids wasted time on ineffective treatment or running around trying to find what works.

That’s one way that you can adjust the pricing presentation, and frame it in terms of long-term value. Another component is that you can break down what’s included. I think this is a fine line. Honestly, if any of you have done consulting with me, you know I’m a big fan more of selling the outcome versus the process, but at this stage of the game, I [00:19:00] think there are a lot of clients who are balking at a large price tag without realizing what they get.

So I think it is worthwhile at some point, not front and center, but on your website, you can break this down and say, okay, this is the testing we do. This is what you get, the feedback session, the school observation, customized recommendations, the follow-up afterward, if you do that.

I think that is worthwhile because sometimes people just hear these numbers and they equate it to going to a primary care physician and doing a 15-minute appointment and walking out with medication. So this is a huge leap from that. I think we do need to spell it out for folks, especially now when we’re trying to convince customers of the value of our services.

And then the last strategy that you could do in terms of reframing the pricing is think [00:20:00] about or communicate the cost over time. So $2,500, you could say something like, that’s about $200 per month if you spread it out over the year. So that’s about the cost of a single therapy session. If that’s something that resonates with them, that’s great. You might need to find a different example if it’s not therapy, but maybe it’s like, that’s a tutoring session or that’s a gym membership at a really nice gym or whatever it may be to spread the cost out over time.

That was a lot of website stuff. Let’s talk about payment and pricing flexibility. A lot of you are already doing this, but it’s worth emphasizing that instead of changing your pricing or charging your pricing all at once, you can do a lot of things to make the payments easier in order to improve conversions.

One of those is offering payment plans. So this would [00:21:00] be what a lot of people probably do. You could do it like, a deposit is due to book the appointment. Then another payment is due at the intake, and then a payment is due at testing, and a payment is due at feedback. So you could break it into three or four payments that occur over the course of a month, let’s say.

You could also go more formal and do something like breaking everything into a 3-month installment plan. So deposit for booking the intake, then the next payment is due a month later, and the next payment is due a month later. Of course, this runs into solving the problem of having a reliable payment method. That’s where credit cards come in handy. And making sure that the card is valid. So you can work that many different ways, but offering a monthly installment can help.

Another option is to split the assessment into phases. [00:22:00] You can start with a very affordable initial screening that people attend before committing to the entire evaluation. Maybe someone comes for the intake, and the intake is $300. If they continue with the assessment, then it goes toward their balance for the assessment, but if they stop after the intake, then they only pay the $300.

It helps build trust and rapport and increases the likelihood that they would continue once they meet you, but it also reduces the psychological barrier of a large upfront cost. So if you let them know, hey, you can just pay $300 to get started and then we’ll decide at that point, it’s just a little more psychologically appealing.

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

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Let’s get back to the podcast.

And then the last option is, and this is controversial, you would have to build into your pricing model to account for this, but you can do a discount. So if you’re a private-pay practice, you could offer a slight discount for paying in full upfront. So when they come in for the intake if they want to pay in full upfront, maybe you do a 5% discount to reward that behavior, so to speak.

Like I said, this is a little bit controversial and it does affect what a super bill might look like and so forth, but I think there are ways to do this and have it make sense. [00:26:00] So you might consider a prepaid discount to get the full payment upfront. And that’s just psychological. 5%, it could be a substantial amount but people just like getting a discount.

Okay, so that’s a pricing discussion. Let’s move to more of a discussion about the selling process and how you can improve your conversion ratio during the phone consults. I’m assuming at this point that you can get people on the phone. If you are not getting people on the phone, I would work to do that.

So the initial inquiry or call to action to me needs to be an online form or some digital means of letting them book, but then you want to get on the phone or in person with them to speak directly to them because this is how you’re going to convert into full evaluations. So [00:27:00] whether you are training your intake staff or you are doing this yourself, these points are applicable.

Scripting is important to address cost concerns. One of those things, just a simple example is, I totally understand that this is an investment. A lot of families worry about the cost, but what we hear time and time again is that getting that clarity now prevents years of unnecessary frustration and expense from running around trying treatments that don’t work. So you can train your intake staff to script a little bit. And this is a little more salesy, but it’s also true. You don’t want to say anything that’s untrue.

Another component is you can train your intake staff to normalize the cost hesitation. So this would be something like, hey, we know this is a big decision. A lot of families are in the same boat or a lot of people are in the [00:28:00] same boat. And that’s why we offer a payment plan, free consult, whatever it may be to help get them in the door.

Another factor or strategy that you can use to improve conversion rates is to use some scarcity to create urgency, if it is true, of course. You could say something like, we’re currently booking, for us, it’s 4 to 6 months out. So if you’re considering an evaluation, I recommend reserving a spot now. You can always cancel it later. Don’t say that if it’s not true, but you can always cancel later, but I just recommend booking a spot now to reserve your appointment.

And then to add on to that, if you know that it’s true is, you’re likely going to call around and find similar wait times at other places. I could save you some time and be happy to just get you on the schedule now, and then you can give me a call back if you need to change it. So creating a little bit of [00:29:00] scarcity can work wonders.

One last strategy when you’re on the phone is to make it easy to say yes. This sounds very salesy. Just get them to yes. I think there’s something to that. If people are feeling hesitant or you get to the end of your phone script and it’s time to do the booking, instead of asking if they want to book or waiting for them to tell you they want to book, you could ask, would it be helpful if I just walked you through the next steps, or would it be helpful if we just look at the calendar? Could I help you get this next appointment booked? Something like that versus leaving it at that.

I’m a big fan of transparency when you’re on the phone with people. And so I think it’s important to address this whole thing of why not use insurance and just talk about that head on. You [00:30:00] can do that in your website copy, like I mentioned earlier, but when you’re on the phone with people, you can always say, yes, we know we don’t take insurance but a lot of insurance-based assessments are brief and they lack the depth that you need for truly tailored recommendations.

Our evaluations go beyond the diagnosis. We’re going to give you a roadmap for the next 1 to 2 years to make sure that you have the highest chance of being successful, something like that. You just address it. You acknowledge you don’t take insurance and then you tell them why and you play up the advantages of that.

You can also offer some insurance reimbursement help. You could create a one-page pdf that walks people through not using insurance. If you use a service like Mentaya, Thrizer or any of those out-of-network assistance services, you [00:31:00] can talk them through that and what that would be like.

You can provide a prefilled super bill template, or show them what a super bill looks like and how to submit it with a little step-by-step guide. You can put together some materials to help people navigate using out-of-network services. And that can also help too, if you tell them on the phone, hey, we’ve done this a million times. We will hold your hand and make sure you get this submitted so that we can increase the likelihood of getting reimbursed.

Alright, what else? Let’s talk a little bit more about the pricing. I should have thrown this in earlier, but I’m thinking about lots of different things here and bouncing around. So one of the things that you can do, we’ve talked a lot about pricing on this podcast. You can create tiered services if you’d like.

You all know, I am not a [00:32:00] huge fan of tiered services, but if you did, here are some options that would help people have a little more buy-in and a little more willingness to consider your different options. For example, you could have a basic evaluation where you do the testing and write a short letter to summarize the results; a one-page report, so to speak.

So that could be your basic. You could do the comprehensive where you do all the testing and a full report, for example, and then that is more money. You could also add even a premium tier, where you do the full testing, full report, plus three months of follow-up, where you meet with the family once a month to [00:33:00] help strategize and support them if you can fit that into your scope of practice.

So this is a good, better, best pricing model to give people choices. Don’t give people choices that you don’t want to fulfill or that you don’t feel are helpful, but we’re thinking outside the box here to try to increase the perceived value and give people choices as to what they book into. And we want to increase the conversion ratio.

Another facet of improved or added value is if you present things as being free, for example. So even though you’re going to bill the cost of these services into the evaluation, you can present them as free add-ons. This would be something like, we include a meeting with school staff for no additional cost to help transition from [00:34:00] our evaluation to school intervention, or we include no cost workplace consultation to figure out how to talk to your employer about your diagnoses and needs at work, something like that.

People love the perceived or their perception of getting something for free. And you can bill that into your evaluations as well. Use psychology to improve the perceived value.

Getting back to having people book into a low-investment option, if you’re not doing free or low-cost consultations, I think it is worth a consideration. Even if you have an admin person who is booking the intakes, if you offer the option for a 15-minute consultation just to let people talk to “the doctor” [00:35:00] and hear from you, hear about your approach, I think that can be a really nice move. The conversion rates for clients once they actually meet with a clinician are usually pretty high. So it could be a brief phone consult. I probably wouldn’t do an in-person appointment for 15 minutes.

And if you absolutely cannot do it for free, then charge something nominal like $50 to do a “free consult”. Obviously, you wouldn’t call it free, but $50 consult just to have them meet you. And then you can apply that toward the full assessment if they continue.

Another option that you could do as a low-commitment entry point is to give them a checklist or a screening tool before the full assessment. So this will be something that happens on the website unless you’re doing an in-person [00:36:00] consult. You do a very brief free or low-cost screener that they can fill out on the website.

Of course, we’d want to do a research-supported screener that they could fill out. It’d be open source and get the results and then you bill that into the workflow or the sales flow where if the results indicate a potential diagnosis, then they can give you a call to schedule their evaluation.

The last thing that I’m going to talk about in this whole process is what I will call strengthening the follow-up after the calls. We have this happen a lot in our practice where people will get off the phone with our intake staff and they give some version of, I need to think about it or I’m going to call around and see what else is out there, or I need to talk to [00:37:00] my partner or spouse about this; some version of that. Basically they are delaying, and it’s usually because of the cost and the investment. And so I think it goes a long way to immediately follow up and not just trust that that person will call back.

What we have started doing is booking that person into another screening call the following week so that they have an appointment to talk with us again about the evaluation process. Some other things that you can do are send an email immediately after that call with the following items. You can do a recap of your conversation. You include an FAQ on pricing and payment options, and testimonials from families who hesitated, but saw the value. And then a booking link that has a little bit of urgency built in that says something like, like I mentioned, we’re booking 4 months out, so you can schedule your appointment right here [00:38:00] and reserve your spot.

I’m a huge fan of creating a template of this. So you create a template where you can put the person’s name in really easily, but these other components that I mentioned are just built in and it’s built into the template. So you are not recreating this email every single time.

And then if you can automate this process, great, if not, you do it manually, but then you follow up again in a week if they haven’t booked. So this is where something like a CRM could come in really handy, but you can also do it manually. You can use a spreadsheet. So follow up again, if they haven’t booked and send another email with similar information. The hope is that they will feel compelled to book that appointment.

There is some data out there around people need to be contacted or given the opportunity to buy something several times before [00:39:00] they commit to it. You’ve maybe experienced this if you’ve looked at something online and then come back to it two, three, four, maybe even five times. And so we’re not going to pester people and send them five emails after they have a screening call but it does go a long way to send two emails. You send one right after and then one after a week if they still haven’t booked.

Pulling this all together, one, you’re not alone. If you saw the episode title and started to weep, you’re not alone. This is happening around the country. I’ve talked to several people who are having this experience, but there are also some strategies that I think you can do. It will require some more effort and some work, especially for those of you who’ve been around for a long time and are used to not having to market. I get some of that, we had to start doing some marketing about a year ago for the first time ever.

So what can you do? You can experiment with different payment options, [00:40:00] installments or splitting things up, train your intake staff on how to, it’s called objection handling; reducing the sticker shock, reframing the cost as value, things like that. You can think about doing free consults or a low-cost screener to get people in the door. You can make sure to communicate the case for private-pay versus insurance-based testing. Make sure that’s clear everywhere. And then improve the post-call follow-up from your intake staff to nurture any clients who might be hesitant to take the leap.

So lots of options out there. You don’t have to do all of them. You can pick the ones that make the most sense for you. Just know you’re not alone and there are definitely some strategies to help you with this dilemma.

All right, y’all. Thank you so much for tuning into this episode. Always grateful to have you here. I hope that you take [00:41:00] away some information that you can implement in your practice and in your life. Any resources that we mentioned during the episode will be listed in the show notes so make sure to check those out.

If you like what you hear on the podcast, I would be so grateful if you left a review on iTunes or Spotify or wherever you listen to your podcasts.

If you’re a practice owner or aspiring practice owner, I’d invite you to check out The Testing Psychologist mastermind groups. I have mastermind groups at every stage of practice development; beginner, intermediate, and advanced. We have homework, we have accountability, we have support, we have resources. These groups are amazing. We do a lot of work and a lot of connecting. If that sounds interesting to you, you can check out the details at thetestingpsychologist.com/consulting. You can sign up for a pre-group phone call and we will chat and figure out if a group could be a good fit for you. Thanks so much.

[00:42:00] The information contained in this podcast and on The Testing Psychologist website are intended for informational and educational purposes only. Nothing in this podcast or on the website is intended to be a substitute for 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 [00:43:00] area. Similarly, if you need supervision on clinical matters, please find a supervisor with expertise that fits your needs.

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[00:00:00] Dr. Sharp: Hello, everyone. Welcome to The Testing Psychologist podcast. I’m your host, Dr. Jeremy Sharp, licensed psychologist, group practice owner, and private practice coach.

Many of y’all know that I have been using TherapyNotes as our practice EHR for over 10 years now. I’ve looked at others and I just keep coming back to TherapyNotes because they do it all. If you’re interested in an EHR for your practice, you can get two free months of TherapyNotes by going to thetestingpsychologist.com/therapynotes and enter the code “testing”.

Thanks to PAR for supporting our podcast. The BRIEF2A is now available to assess executive functioning in adult clients. It features updated norms, new forms, and new reports. We’ve been using it in our practice and really like it. Learn more at parinc.com/products/brief2a.

Hey, folks. [00:01:00] Welcome back to The Testing Psychologist podcast. Today, I’ve got Stephanie Tsapakis, who is the CEO and founder of LD Expert, a company that specializes in online reading intervention and academic tutoring for students with learning disabilities. LD Expert partners with neuropsychologists nationwide to build referrals and help students.

We haven’t done an episode on dyslexia in a long time, and this is a pretty fun and informative conversation for me to dig in and get the updates on where we’re at with dyslexia and intervention, and how Stephanie and her team go about supporting these students. We talk about lots of different things. We talk about Stephanie’s journey, starting the company, and some personal experience; having a daughter with dyslexia.

We talk about the way that they deliver this intervention online; which I was very curious about, how they do progress [00:02:00] monitoring in a way that is accurate and not subject to practice effects. We talk about length and duration of intervention. We talk about types of intervention, and what’s supported by research. So lots of information here in the episode for you to check out.

Before we get to the conversation with Stephanie, I’ll invite you to check out consulting options through The Testing Psychologist. At this point, the small group masterminds are full and running for the first half of the year cohort. The next cohorts will start in midsummer, but there is the option to do a strategy session if you just want to get some one-time one-off support in building your testing practice. Happy to chat with you. You can go to thetestingpsychologist.com/consulting to get more information and schedule a pre-consulting call to see if it’s a good fit.

[00:03:00] All right, let’s get to this conversation with Stephanie Tsapakis on LD Expert and reading intervention for kids.

Stephanie, hey, welcome to the podcast.

Stephanie: Thank you for having me. I’m excited to be here.

Dr. Sharp: I’m excited to chat with you as well. I think there’s a lot of overlap in the work that we do. So I’m very grateful that you are here.

Stephanie: Yes. Me too.

Dr. Sharp: I will start with this question that I always start with, and that is, why do you spend your life doing what you do?

Stephanie: It’s a great question and such a complicated answer, I’m sure, for everybody. I’ve always been passionate about education in general. When I was 7 years old, I [00:04:00] asked for a pointer for Christmas so I could play teacher. It was the only thing that I wanted.

Dr. Sharp: Oh, that’s great.

Stephanie: I knew very early that I wanted to be a teacher. And that evolved over my lifetime, through my career in education into helping students that learn differently, making sure that they could also reach their full academic potential, and just exploring the ways that we can reach these kids that maybe need some accommodations or content delivery modifications and things like that so that they feel successful too.

Dr. Sharp: That’s meaningful. I can’t believe you asked for a pointer as a kid. Did your parents get you the pointer?

Stephanie: My dad made one for me. I still have it in my office. It’s in a very prized place. I kept it in my classroom when I was in the classroom. My kids will try to play with it sometimes and I’m always like, no, that’s really special. You can’t touch that.

[00:05:00] Dr. Sharp: That’s a special pointer. Yes. That’s fantastic. Nice. Tell me a little bit about the origin story here; how did you come to build LD Expert?

Stephanie: I was teaching in the classroom. My classroom career was primarily in private schools for students with learning differences. So every day on the way to school, I would call my best friend. She worked in an online company that provided speech therapy, occupational therapy, and counseling services to students in online schools. So we would often talk about how there was a need for dyslexia intervention in online schools, and it was a need that was not being met. And so it was something that we knew was there, but never really had time to do anything about.

[00:06:00] So then came COVID. When COVID hit and the world closed, we had all this time on our hands because everybody was home all day and everything was now moving online. So that forced me to convert my dyslexia therapy materials into an online format and gave me the opportunity to take a step back and look at my teaching career then decide, I don’t know if this is going the direction where I’m reaching as many people as I want to.

So I decided to just tutor online for two years to see where that went. And that is what exploded into our wonderful company, LD EXpert now. I had so many parents looking for that specialized instruction that they didn’t feel like they were getting enough of or a good enough quality in their schools. [00:07:00] So I kept having to hire teachers. And so now we’ve made it our mission to serve students nationwide for dyslexia intervention, general academic tutoring needs and focus on those students with learning disabilities specifically.

Dr. Sharp: I wanted to chat with you because I feel like this is a question that comes up a lot among the neuropsychologist community or psychologist community. Certainly here locally, I feel like we have a really hard time finding good tutors who are following research-supported intervention and know what to do or have availability. There’s both of those problems.

Stephanie: Yes.

Dr. Sharp: Were you finding that as well? Was that a part of this?

Stephanie: Definitely. I think that is what initially was bringing a lot of families to us, is that [00:08:00] they were finding those struggles as well. It’s also partly what makes us unique for the company that we are.

When a neuropsychologist is looking for someone to refer to, I would imagine the majority of the providers out there are individuals, so you run into that availability issue a lot where they’re either full and you have to keep checking back in to see when they have availability, or you have to keep checking back in to make sure that they still have availability if you have been referring to them because that’s really frustrating for families when there’s a waitlist and they have to wait even longer to get their kid the help that they need.

So I think one of the things that anyone who’s looking to build that referral relationship should look for in a provider is, like you said, that they’re providing [00:09:00] research-based interventions, that they’re certified in that intervention, and that they’re able to provide that intervention with fidelity.

Because that’s one thing that those of us in the field get really frustrated about is we’ll have miss whoever, a retired elementary school teacher who happens to have the materials for an intervention program but never went through the certification process to be able to provide that program to fidelity and they’re advertising themselves as, hey, I’m using X, Y, and Z program, but they’re not always using it correctly. Not that they’re not still helping children, they likely very much are but possibly, the families maybe getting less bang for their buck in that instance.

I think definitely looking for someone that’s certified in the programs that they’re using is extremely important [00:10:00] as well as those programs being good programs to begin with.

Dr. Sharp: I’m so glad you brought that up. This is not something that I necessarily look for or ask about when I’m looking for folks to provide these interventions. Tell me a little bit about the certification process for some of these intervention programs and why that’s different than being trained into the program.

Stephanie: I’ll talk about the Wilson Reading Program specifically. That’s the program that all of our dyslexia therapists use. And so that’s the one that I know the most about here.

There’s a lot of teachers who will say that they’re trained in the Wilson program, which basically means that they have done the initial three-day overview workshop of that program. It’s a great introduction to everything. It explains all the materials. It explains the methodology behind all of the parts to the [00:11:00] lesson, but that’s basically it.

So from there you can go on to become officially certified, which requires Master’s level coursework to go through each of the steps of the program and that’s all online through the Wilson Academy in their company, and also a supervised practicum. So this has to be one-on-one with a student. The student that you choose has to be approved by the program specifically.

So we have to collect either a recent neuropsychological evaluation or maybe administer the WIAT or something that our qualifications allow us to administer, collect that baseline data and have the student approved before they are allowed to be our practicum student. That’s to make sure that we have the right profile that fits what’s appropriate to implement this program to [00:12:00] fidelity so that way we’re not wasting our time or the student’s time and that they’re going to do well on the program.

The practicum length is 12 months. There are some people that end up needing to extend that, so anywhere from maybe 12 months to 15 months, where you are supervised five different times and given an evaluation of your lesson to make sure that you’re delivering all of the parts of the lesson to fidelity before you are allowed to be supervised.

I will tell you that Wilson Language Training specifically is very strict on these evaluations. They do not hold back. They give very constructive feedback to teachers and they will not pass you in this practicum unless you are doing things the way you should be.

Dr. Sharp: Okay. That’s way more extensive than I imagined. I’ll be honest, I had no idea what to expect, but I thought you would maybe [00:13:00] say you had to do 50 hours of training or something, but this is like a full-on almost postgraduate degree or something.

Stephanie: It feels like it at times. There’s a lot of documentation with it and progress monitoring. You submit your lesson plans and the progress monitoring. And then at the end of the practicum, you administer assessments again to show the growth that the student made to make sure that the program was actually effective for them. So it is very involved. Obviously, well worth it because it’s a great program, but there’s a difference between someone who has been certified and someone who has not for sure.

Dr. Sharp: That’s good to know. So how would we know that? If we’re screening referral sources, do people put this on their website or do we have to ask? How does that work?

Stephanie: You could always ask. Gosh, those of us that do it, I have in my email signature, my Wilson, a dyslexia therapist badge. We get a little logo that we can use for [00:14:00] things because I know I’m super proud of it. I’m sure all the teachers who’ve gone through the program are very proud of it. It’s a lot of work.

They should definitely advertise it. I would imagine that they’re certified in the program, but for sure asking. If you say, are you certified and they’re not sure how to answer, you can always simplify it by saying, did you complete a supervised practicum with this program? The answer to that will let you know if they’re certified or not.

Dr. Sharp: Sure. That’s good to know. I want to talk about intervention programs. Big picture, I think a lot of us have heard of Orton-Gillingham and then there are variations under that. I think Wilson is one of those. I’m curious, right now, early 2025, what is the state of the research on intervention?

Let’s stick with [00:15:00] dyslexia. What’s the state of intervention? Is it still Orton-Gillingham? Are there other approaches that are effective? How do we look at this?

Stephanie: The International Dyslexia Association is the gold standard for setting the bar for those types of interventions when we’re talking about dyslexia. It gets a little bit complicated when we look at it at a state level because every state department of education is going to have their own approved programs for dyslexia intervention in their schools.

There are some states that don’t call dyslexia, dyslexia in the school. So it’s just an SLD in reading, for example, what interventions fall under that, but still Orton-Gillingham-based intervention programs are the gold standard. So they would need to be multisensory. They would need to have [00:16:00] the explicit instruction as a piece of them. They would need to be structured, sequential and follow that specific program. All of those things that an Orton-Gillingham program requires.

So that could be another thing that you ask about is how do you make sure that you’re meeting all of those standards of delivering a program. Especially because all of our services are online, we often get asked, how do you make your sessions multisensory if you’re delivering them online?

Dr. Sharp: Great question.

Stephanie: Fair question. Wilson builds a lot of that into their program with tapping sounds on your fingers, tapping syllables on your arm or on the table, and skywriting. There’s specific student materials for the Wilson program that every student should have a magnetic letter tile when they’re doing their session, and that’s for the spelling portion, the encoding piece of the session. [00:17:00] We purchase those for all of our students and mail them directly to their houses. So that way we do keep that multisensory piece in the lesson.

That’s another important thing to talk about when you’re interviewing a provider, when you’re asking about the fidelity of the program if they’re using all of the parts the way that they’re supposed to be used, and the materials for the session as well.

Dr. Sharp: Got you. How did you pick Wilson out of all the variations?

Stephanie: Good question. I stumbled into Wilson, lucky for me, because now, if I didn’t know everything I knew back then and I know it now, I would still choose Wilson. The high school in Ohio where I was teaching offered five or seven of us to be trained in Wilson if we wanted to. I was a 22-year-old.

Dr. Sharp: Bright-eyed in [00:18:00] search for things.

Stephanie: Bright-eyed, super energetic teacher.

Dr. Sharp: Ready to conquer the world.

Stephanie: I was like, I’ll do it. I’ll do more school. I just started my Master’s program. I was lucky that I did it early on in my career and then it was offered to me. I know now the reason why I would always choose Wilson is because in my opinion and in my experience with a lot of other programs, it is the most comprehensive in terms of decoding explicit instruction and the scope and sequence making sense for the decoding piece that directly ties into the encoding.

They have a lot of spelling practice and a lot of other multisensory activities for encoding specifically in the program that some other programs very much fall short of. They’ll focus on their reading [00:19:00] piece, the decoding and maybe even reading comprehension, but that encoding piece tends to fall off a little bit.

And then there’s also very explicit and detailed interventions for reading comprehension in Wilson as well. So in every lesson, if you’re doing all the parts of the lesson correctly, you should be hitting decoding, encoding and reading comprehension in every single lesson

Dr. Sharp: That is fantastic. I have run into a few folks who do Wilson. Barton seems to be pretty popular as well. I have a colleague here who does Barton. Those seem to be the main ones that I run into. I’m just curious how you pick.

Stephanie: Those are big ones. Here in Texas, where also Take Flight is a popular program, both in our schools and certified academic language therapists here can go through the Scottish Rite Testing Center to get their certification to become a cult, because Take Flight was a Scottish Rite [00:20:00] program, that’s typically what they trade in.

I think that’s a great program as well. My daughter was just found eligible with dyslexia at school, and she’s doing Take Flight in her school. I’m a Wilson dyslexia therapist, and I still have her doing Take Flight. I’m not doing any additional Wilson with her because I do trust the program. I think more importantly in the program though, is the practitioner.

Dr. Sharp: Okay, say more.

Stephanie: I feel like a lot of the Orton-Gillingham programs all have the Orton-Gillingham pieces to them. It’s not that one is so significantly better than another one. Don’t get me wrong, there’s still some pretty terrible ones out there.

In terms of the popular ones, I think that they all have positive things to offer, but the practitioner is so much more important because the child has to feel [00:21:00] safe with them, first of all. They have to be able to build a relationship with them so that way they’re engaged in the learning and none of these programs are scripted to the point where you’re not having to constantly use your professional judgment to make changes to the lesson to meet an individual need.

So I think that’s where the certification piece is very important but also just having an experienced professional practitioner who knows the importance of also having a relationship with the student is so important.

Dr. Sharp: That makes sense intuitively. I think that’s probably what a lot of folks say about the work that we do. We’re administering a lot of the same tests and it’s a similar process, but the connection with the client and the family is the most important thing.

Stephanie: It’s not fun to sit through hours of [00:22:00] testing. Phonics isn’t super fun in terms of all the subjects in school but if you have a relationship, then you can make it more fun. You can make it more engaging. You can make it more pleasant for the person involved.

Dr. Sharp: Absolutely. That totally makes sense. And that makes me think too about something that you said when we talked before we set the recording was that y’all try to focus on intervention that’s neurodivergent affirming. I wanted to spend a little bit of time on that. I’m fascinated by this idea of neurodivergent-affirming or just affirming work. This is something that a lot of us are thinking about these days. And so I’m trying to get everyone’s perspective on what that means. So when you’re providing neurodivergent-affirming, especially online intervention, I’m curious what that means.

Stephanie: So this is two-pronged for us. [00:23:00] There’s the piece that we do with the student during our actual sessions and then there are our business practices in our companies that we use. So to address what we do with this student first, no surprise to the community that probably listens to your podcast is that we oftentimes have comorbidity with learning differences. We have a lot of students that not only have dyslexia, they may have attention difficulties, dysgraphia, autism spectrum disorders, or you name it. All of these other things that are going to impact their educational profile.

So one of the biggest things that we need to make sure that we’re doing in all of our sessions with our kids is making sure their emotional, physical and sensory needs are met. That relationship piece, again. We always default to [00:24:00] prioritizing our relationship with our student above everything else.

Even if that means the first 10 minutes of our session we’re not doing any Wilson, we’re talking about what happened on the school bus, why your feelings got hurt, and how you can handle it the next day, whatever we need to do to make sure that the student’s emotional needs are met first is what we’re always going to prioritize.

That could also mean that sometimes we end the session 10 minutes early because they’re just squirrely that day. Maybe there’s a full moon and the attention is gone and I say, alright, I know you worked hard, let’s play a game today where we’re going to do this online game instead with our phonics role, we’re not going to worry about doing this piece of the session today. That’s one thing.

Movement needs is the other biggest thing that comes up for us. We have these students that have attention [00:25:00] issues, and we know that our brains work better when our bodies are able to move. So we have students spinning around in their chairs at their computer while they’re doing their session, maybe they’re standing up, sitting on a ball, or literally doing cartwheels in their bedroom on the screen. For us, it’s not distracting. We don’t think too much of that.

Some parents initially are horrified if they walk in on a lesson and they’re like, what are you doing hanging upside down on your gymnastics bar and reading? We’re usually quick to respond and say, it’s fine. They’re engaged. They’re doing the activity I asked them to do. If they want to hang upside down and read, it’s fine. As long as they can, we’re fine with it.

So just making sure that we know that when a student is moving around, it’s not to be disrespectful. It’s [00:26:00] not because they aren’t engaged. It’s just them expressing a need in order to stay engaged. We are experienced with it, understand it, and don’t take it personally is important.

Dr. Sharp: It is important. I’m glad to hear you say that. I feel like schools would be so much better off if kids could stand up or just move up and down a little bit while they are doing their work. It helps so much.

Stephanie: It’s why I bought a treadmill underneath my desk two weeks ago, so that I can stand up and walk a little bit. When I’m stuck at my desk all day, I need to move in order to stay productive. I’m allowed to do that. Why? Because I’m an adult. We should allow kids to do that and tell us those needs as well, for sure.

Dr. Sharp: It’s super important. I don’t think a lot of people watch the YouTube videos of these podcasts, but you can see I’m always moving [00:27:00] around at my standing desk. I’m stretching, moving back and forth, going on my tiptoes and whatever.

Stephanie: We’re both standing in this.

Dr. Sharp: Oh yeah.

Stephanie: Clearly we’re both meeting our own sensory needs.

Dr. Sharp: Totally. That’s great. I could see though, parents are like, what are we doing here? Is this actually working?

Stephanie: It’s something that I’m strangely passionate about this seemingly small thing because I think that somewhere along the line that became communicated as disrespect and it’s not. I wish that wasn’t so conditioned inside of us that you have to be sitting down, not wiggling around a lot, paying attention, yes sir, yes ma’am, in order to show that you’re respecting a teacher or engaged in something, and it’s just not the case. These are kids, man. They got to move.

[00:28:00] Dr. Sharp: Absolutely. I like this. So that’s one side of the neurodiversity-affirming approach. I’m intrigued by this component of the business practices as well. What do you mean by that?

Stephanie: I have the saying that the families that we work with are the trees from which our apples fall. And this is very much the case in my household.

So speaking of myself here as well, I think a lot of parents probably when all of you psychologists are sending the questionnaires home, they’re filling them out and thinking, I did that when I was in school. I remember feeling like that and all of a sudden it’s like, wait a second, maybe I’m ADHD, and that’s why my kid has it, and this light bulb goes off.

We know that learning differences are oftentimes hereditary, and executive function skills [00:29:00] are oftentimes a little bit more lacking in those of us of the LD community. What does that mean? Things like scheduling appointments, paying bills, communicating, setting up consultations, and following through with checking your schedule and finding a teacher and all those things, those are skills that might be difficult for the population of parents who need to find a tutor for their child.

So having that in mind, we try to make the scheduling of an initial consultation very user-friendly and simplified with one button on our web page in multiple places. When we do meet with parents, we have the same ideas of how I would explain this to a child of what we’re going to do in the program. I’m going to explain it the same way because you don’t know the acronyms. You’re not a dyslexia [00:30:00] therapist. You don’t know all of the reasoning behind what we do. So really taking our time and not rushing that piece where we’re explaining the programs to our families.

And then from there, just a very simplified process of getting things rolling. So once we have a family decide they would like to contract with us which is another thing that we do in terms of our contracts, we don’t have any long-term commitments; not a friendly thing for neurodivergent families. We just ask for two weeks’ notice if you ever want to terminate a contract with us. And that’s more a protection for our teacher’s income more than anything else.

We basically just say, give me your best times according to your schedule and your child’s needs. Do they need a snack after school and some decompression time? Do they need to start right after school? Because at seven at night, they’re done. There’s nothing [00:31:00] else happening.

And from there, we do everything else. We schedule it, we reach out to the teachers, we send an email to the parent with the links from the teacher, the contact information from the teacher. We input them into our online software that does our scheduling, our automatic billing, and our automated reminders.

We try to set up our reminders so that it complements our cancellation policy. For example, we require 8 hours’ notice for a session to be cancelled. And so we send a reminder 9 hours before your lesson. Sometimes we tweak those; if there’s an early morning lesson, we’ll set those to a different reminder time. But we have those and then we have a two-hour reminder that comes through email as well and just trying really hard to build in as many accommodations as we can specifically for executive function skills.

[00:32:00] Dr. Sharp: I like all of those things. These are ideas a lot of us can put into effect in our businesses because that applies to us too; the kids that we’re assessing typically have adult parents who are similar in some regards.

Stephanie: Yes.

Dr. Sharp: These are great ideas. I’m going to ask you a detailed question because I’m curious in this, and that is, what software do you use for billing, scheduling reminders? What’s the tech stack here?

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All right, let’s get back to the podcast.

Stephanie: Good question. So right now we’re using something called TutorBird, which is great for us. It’s amazing. All of our teachers have their own login with their own schedule. They can put their availability in there, although we have a separate document where they keep all of their availability and they can tell us, green means I want to work here. Pink means I do it if I have to. Gray means I’m definitely not available.

That works really well because it does our invoices automatically and that’s [00:35:00] directly related to the schedule on there. So if a teacher deletes a session, immediately the account gets updated and all of that stuff is connected, which is really nice. We would love eventually to have our own platform that’s a pipe dream, especially if my business partner would really like to have that one day.

I’m more of the cautious one in that I think, oh my gosh, that would be such a headache to have to change everything over to our own system if we ever want to do that but she’s really passionate about it. It goes back to that ease of use idea where if we don’t have to have a bunch of platforms, if we don’t have to have Gmail, TutorBird, Zoom, this, that and all these other logins, if it can all just be in one place, that would be great, but we don’t quite have that yet.

Dr. Sharp: We’re in the same boat. [00:36:00] I’m always trying to figure out how we can streamline our software and it is tough.

Stephanie: You can make your own for a bajillion-dollar, but we don’t have that either.

Dr. Sharp: I know that’s always out there but like you said, tons of money, tons of time. It is. That sounds good. Software is important. I like these neurodiversity-affirming practices on both sides.

Can you break this down just a little bit more for me? I am very interested to hear what this actually looks like practically. Let’s say, my kid is getting tutoring through LD Expert. What does it look like when we sit down to log in and then what am I seeing on the session if I were to watch?

Stephanie: You would get an initial email from the teacher that’s assigned to your student, and they’re going to have their personal contact information and their Zoom link in there. So that would be what you would click [00:37:00] on to start the lesson. That first lesson is going to be primarily relationship-building. We’re not looking to do a full Wilson lesson the first time we meet your student. It’s also going to be focused on collecting baseline data.

Part of the Wilson program is they have an initial placement assessment where it goes into detail of the scope and sequence of the program and having students read through lists of words in order of how the program progresses. So if I do this part with a student and the wheels start falling off the bus at list four, that tells me, okay, in step 4 of the program, we’re likely going to need to slow things down, dig in and focus on that part. So we would collect the baseline data and then we would share that with [00:38:00] you.

Another great thing that TutorBird does is when our teachers go in and they write up the lesson summary for the day, they’re going to include in that, which is another really important thing to look for in a provider if you are interviewing providers for referral sources, is that they’re sharing data with their families every single time they meet with the student.

Dr. Sharp: Yes. I want to ask about that. Can I jump in there?

Stephanie: Do it.

Dr. Sharp: I wasn’t sure. I definitely wanted to ask about the feedback in the ongoing measurement process. So whether now’s the right time to talk about it or if we want to pin it and come back to it in a few minutes, you let me know.

Stephanie: I’ll throw it in here because it’s part of what to expect from your lesson. So I think this is a perfect place to talk about it. Our teacher would go in, they would put in their session notes, they’re going to include the data in there. Wilson specifically has a charting piece where we’re looking for students to [00:39:00] read 15 out of 15 real words correctly or 13 out of 15 nonsense words correctly before we’re moving on. They’re going to have that data tracking in that session note, and all they have to do is click the checkbox that automatically emails it to the parent.

The parent also has their own login where they can go in and look at all of the session notes, the history of them if they wanted to, but they’re definitely getting that immediate feedback after every single session. And then from there, the kids get pretty comfortable and they are always usually pretty comfortable with technology to where parents don’t actually have to be anywhere near them for the lessons typically.

Even my 7-year-old who had her working with one of our teachers for a little while before she was officially qualified with dyslexia when she was going through the testing process with the school, she did not need me there and she had never worked on a laptop before ever. She has [00:40:00] iPads and things in school where she’s worked on tablets before, but I was thinking, I don’t know if she’ll be really great at using the mouse or knowing what to do here. She figured it out pretty easily.

Dr. Sharp: It’s amazing.

Stephanie: It’s really nice. In terms of what to expect from a parent, there’s not a whole lot you have to do other than that initial getting them on the lesson and then you can monitor that data tracking piece and reach out anytime. Like I said, we give our personal information out to our parents. If you want to text me and ask questions, go for it anytime.

The lesson content itself; all of our teachers being certified in the Wilson program, they have copyrights to the material that they’re using because they’ve purchased all the materials. So that’s an important piece that we know that when they’re using the actual materials, they are the correct Wilson materials with the program. We’ve put it into an online [00:41:00] format.

Wilson, in particular, recently developed online materials that align with their lesson. So instead of using a document camera to show the page, you can get on through the Wilson Academy and use their projected materials, which are really nice.

We allow autonomy to our teachers in terms of what materials are the easiest for you to use and what you feel like your student responds the best to. So maybe some students have a hard time with the tile board and they want to use one online, or maybe we have a student with severe dysgraphia and writing out this encoding spelling part of the lesson every time is super difficult, we’ll type it. We have a copy of the same page that we can project on the computer and you can use the annotate tools to type. In general, it’s basically the same materials we would use in person, but in an online [00:42:00] format to go through all the parts of the lesson.

Dr. Sharp: That sounds great. Nice. And so they jump on, they do the computer work, you’re working over Zoom. You mentioned you did typical words and nonsense words as two metrics that you’re looking at each time. Are there other metrics that you are checking on each session or periodically?

Stephanie: Yeah. We’re going to look at obviously that turning piece for the real words of the nonsense words every lesson. We’re also going to look at the encoding, both in terms of error patterns in the encoding, so that way we can individualize the lesson next time. We have a huge bank of words that we can choose from that align with the session.

If I have a student that’s really having trouble with digraphs, I’m going to pick a bunch of words with digraphs in them so that we can practice that. And then the reading comprehension piece as [00:43:00] well. Starting with the visualization skills primarily with comprehension and then from there using professional judgment to decide, do we need to draw this out? Should we draw this on the screen? Should we make something on Canva with clip art that has characters acting out the story?

It’s so important that you have that provider because the Wilson program is great, but sometimes we need to bring other things in that the student finds engaging and meets their individual need as well. That’s all part of the whole package.

Dr. Sharp: What’s the typical length of treatment?

Stephanie: Oh, that’s a tough one. I would say it’s typically 2.5 to 3 years to complete the Wilson program, [00:44:00] specifically. I think that a lot of dyslexia programs are the same length. I know the Take Flight Scottish Rite program is 2 years, for example. Barton, also going through all of her steps, if you’re going to do the whole program, it should take around that long.

All of our sessions are an hour in length. We need that whole hour to get through all of the pieces of the lesson. If we have a younger student, we’ll modify it to where we’re doing half of a lesson one day and then the other half another day just for their age-appropriate needs. It’s important.

I think that the biggest piece with getting through the program is that you have to be committed to doing it year-round if you want to begin that biggest bang for your buck. The consistency is so important and that you’re not just doing it once a week. If it’s once a week only, it’s going to [00:45:00] take a way longer to get through.

Dr. Sharp: I was going to ask, is this two, three times a week for an hour?

Stephanie: Based on fidelity of the program, we would recommend three times a week, four times a week is ideal. The more, the better.

Dr. Sharp: Okay.

Stephanie: Primarily, our families stick to two and three days per week. We’ve started recommending very strongly that two days is the minimum. I’m certainly never going to turn a family away that needs help. For whatever reason, they can only make one time a week work, we’re not going to say, no, sorry, we won’t help you. You’ll definitely get more progress, see things moving along at a steadier pace if you can keep to that consistency.

Dr. Sharp: That makes sense. Can it be too much? Let’s say, schedule and emotional energy notwithstanding, just from a reading intervention standpoint, if a kid wanted to come [00:46:00] 7 days a week, could that happen? Is that realistic?

Stephanie: I have never personally experienced a child wanting to come 7 days a week, but if they did, no, there really couldn’t be too much. It’s like saying, can we read aloud too much to our kids? No. Do we all want to sit in front of the bookshelf all day, reading aloud all day, every day? No, we want to do other things, too. You can’t do it too much. There isn’t so much intervention where it would be detrimental.

Dr. Sharp: Got you. I would have to imagine, you tell me though, are most of the students coming after school? It seems like the availability would be limited because you have to squeeze them in between three and seven o’clock or whatever.

Stephanie: That’s part of the reason why we have 30 teachers and whenever our teachers are getting full, we just hire more. Going back to that piece when you’re looking for a provider, if they’re [00:47:00] full, they’re full. And so that might be one benefit to going with a company like ourselves that has multiple providers is that way we have more availability.

A lot of times so many parents get frustrated because their tutor can simply no longer help them. Maybe they’re having a baby, they just over-committed themselves, they’re moving or whatever the reason may be, but that happens a lot that individuals just for one reason or another end up having to stop services and recommend that families find someone else for their child.

In the rare event that something happens with one of our teachers, we have had two teachers have babies, for example, we have this large team that can come in right where that person left off, using the same exact materials, and just continue with the child, which is a really great benefit. I don’t even remember what you [00:48:00] asked me, I went on a tangent there.

Dr. Sharp: I was just talking about the availability and the hours that people, so you just go into it. You just know, hey, my staff is going to be working three to seven o’clock most nights. That’s just how it works. That’s just the kind of business.

Stephanie: It is. We hire almost two schedules of staff. We have people that have daytime availability that serve homeschool students. We do also contract with school districts that maybe it’s a rural district that cannot find dyslexia therapists to come to campus, we can provide services online for those schools. Sometimes schools get sued, and parents have the right to choose their own provider to provide services to students during the school day, we have people that are available during those hours to provide those services, but primarily, most of our students are at those [00:49:00] after school times.

When we’re hiring, we put that in the job posting that these are the hours you would be working, and a lot of times it’s actually good for teachers, even young mothers that want to be home with their kids during the day and they know that they can have a spouse or other childcare in the evenings and work for maybe two or three hours a few times a week and generate a nice income for themselves.

Dr. Sharp: Good perspective, certainly. I have to ask how much it costs. If we’re talking about going two, three, four, five times a week, what can people expect?

Stephanie: This is another thing I think is important for the referral piece; to make sure that you’re not referring to someone who’s super expensive. So nationally speaking, in terms of Wilson-specific lessons, people who are certified tend to be anywhere from $60 to $120 an hour. There’s a very wide range.

[00:50:00] For us personally, we charge $70 per hour for dyslexia intervention services and $55 an hour for tutoring. That’s another value of our company where we want to be able to pay our teachers as much of that hourly piece as we can so that way we can keep teachers, but also have enough to run the business as well.

They’re supporting our teachers in making sure that they don’t have to do extra things. As much as we can prepare materials and have outlines for lessons, we do all of that for our teachers so they’re not spending an hour prepping for a session and then an hour teaching and only get paid for one of those hours.

We try to keep it affordable for families because like you said, it’s two times a week. Private intervention is simply expensive. In this day and age, life is very expensive and we understand that. So that’s another reason [00:51:00] why we would never say if you can only afford once per week, we’re not going to help you.

Dr. Sharp: Right. This strikes me as any number of other things where if it’s important, a lot of families hopefully can find a way to do it. Many of us pay a lot of money for our kids to do sports, activities, or whatever it may be and this is another line item in the family budget then. It feels important.

Stephanie: It’s true. It should be temporary too, like I said, two to three years, which is not a short amount of time. Once you finish a program like this, if it’s done to fidelity, if it’s done correctly, this isn’t the type of tutoring that you continue on for your whole life. It’s not like I have trouble with math calculation, and I’m always going to have trouble with math calculation. These types of [00:52:00] interventions specific to dyslexia, once you finish the program, we should see your standard scores go up, 1,2,3 standard deviations to where you’re able to read in the average range, if not much closer to grade level content.

I think that’s one thing when you look at your investment from a parent standpoint, you want to find someone who’s going to give the best quality instructions. That way, you just pay for it once. You don’t start off with a person who’s $20 an hour because they’re super cheap to realize they don’t know what they’re doing. And now you’ve dumped all this money and a year’s worth of time into this person who wasn’t really doing what they should have been doing, or maybe what you thought they were supposed to be doing, and your student didn’t progress enough.

Dr. Sharp: I got you. You break up a good point that I wanted to ask about, which is expectations, and what kind of expectations parents can have. I [00:53:00] typically, when I’m sending folks for this kind of intervention, I try to be almost overly conservative and tell them, hey, reading’s never going to be a strong point and we can get them hopefully into the average range. Is that an appropriate expectation setting or not?

Stephanie: I love that you said that. I love your and in there instead of but. We don’t want to disqualify the previous statement. No, I think that’s totally reasonable. We always tell families too, dyslexia specifically, it’s not something that’s going to go away. We can’t cure dyslexia, but there’s very effective treatments for dyslexia.

I wish even in our schools, if we had better Tier 1 instruction, the general education classroom, the instruction that everybody is getting, if we could get [00:54:00] that to align with the science of reading, we would have a lot less kids needing this very explicit, intensive intervention. That’s a conversation for another day with our educational system.

Dr. Sharp: That’s another podcast.

Stephanie: I don’t think that’s an unrealistic expectation to set for parents. It falls on the intervention specialist, where if you are working along through the program and you get to a point where you think, we have hit a wall, I don’t know what else to do, I don’t know why we’re not making progress or whatever it may be, that you should communicate that to the family and be honest about that. That’s something else that’s really important.

And also that means that you have to find a provider that understands psychoeducational data. I need to be able to look at the [00:55:00] report that you have compiled on this child and say, oh wow, our processing speed is 79. Okay, we’re going to need to accommodate for that and communicate to parents, I’m looking at their learning profile. Some of these scores would tell me that they may be more likely to move through the program at a lot slower pace. So that might be more towards the three-year spectrum or even longer than that depending on the child’s certain profile.

Just another reason why the provider is so important, because they have to be well educated on all of those pieces so they can also help set appropriate expectations for the family.

Dr. Sharp: That makes sense. I have maybe one last question just to tie it up a little bit. Is there a point where kids age out of effectiveness for this program? Let’s say, we see a fair number of 12, 13, 14, [00:56:00] maybe even high school students where we are diagnosing a learning disorder for the first time somehow, I don’t know how that happens, but it happens sometimes. So is there a point where the intervention is not as helpful as it would be when they are younger?

Stephanie: Definitely not. Early intervention is always recommended because the expectation when a child is younger is more reasonable in terms of closing the gap. So if we’re not diagnosing a child until 13 or 14, and they’re reading on a 2nd-grade level, our gap is huge at this point. It’s going to take a longer time to notice that gap closing as opposed to a 2nd-grade student reading on a kindergarten level, it’s a smaller gap. You’re going to notice progress likely more quickly, [00:57:00] both in their confidence and in their academic skills.

It can certainly be just as effective for 13, 14, even adults. We’ve worked with adults to read in the Wilson program. There’s no age limit on it. It’s just a matter of see that immediate result where you’re are like, I’m noticing this making a difference for me. When you have a wider gap to close, it’s going to feel like that takes a little bit longer.

Dr. Sharp: That makes sense. That’s wild. I didn’t even think about adults benefiting. That’s good to know.

Stephanie: We have a lot of adults that are illiterate in our country, unfortunately, and some of them are very motivated to get help because they just never got it in school. So yeah, we can use it with adults.

Dr. Sharp: It makes me think about this idea of accessible reports, which is a whole other discussion as well. We write these evaluation reports often way over the head of our [00:58:00] audience if the average reading level in the U.S. is something around 7th or 8th grade. We’re not doing our audience many favors by writing at such a …

Stephanie: It’s true. I have parents that seek us out for special education advocacy type services. They come with this FIE from the school and they’re like, I don’t know what any of this means. Can you interpret this for me and help me understand this and then what I need to do with it?

Okay, so you’ve told me my kid is an X percentile, what do I do with that? How do I help them accommodate for that or still achieve in spite of that or whatever it may be? It’s definitely a difficult hurdle. I think that all of us have to remember that we have to come out of our educational lingo in some of our super technical language for [00:59:00] for parents and kids too.

Dr. Sharp: Certainly. This has been fantastic. I have learned a lot during our conversation and I’m excited to maybe send some kids your way. This is super cool.

Stephanie: Please do.

Dr. Sharp: I’d love to. Good segue; how would we refer people if we wanted to?

Stephanie: The easiest way to refer to us is to just send parents to our website. On our homepage and all over the website, there’s a button to schedule a consultation with us. And that’ll take you to Calendly where it shows all of my availability. I’m the one who does our family consultations. They could schedule that at a time that works for them to meet with me and talk about our programs.

We have a resource too, that I’ve shared with you, that if you want to build a referral network and have multiple providers that you can refer to and you’re not really sure how to interview these [01:00:00] providers or what to ask, and what to look for, we’ve laid that all out for you in a handy-dandy handout with checkboxes and graphic organizers where you can compare different providers and the things that they offer, and then make the call that’s specific to your business of what’s the best fit for the clients that you’re evaluating, referring or whatever it may be.

Dr. Sharp: Nice. Yes. We’ll put that in the show notes as always. We love free things that help us make decisions. Great.

Stephanie: We do too. We like free things in graphic organizers over here, all of our teachers. So we’re happy to make those whenever we can.

Dr. Sharp: That’s right. That’s where y’all shine; those graphics. This is great. I appreciate you jumping on. I’m glad that we connected down at NAN and were able to put this together. It’s been great conversation. Thank you.

Stephanie: Yes. Me too. Have a wonderful rest of your week. Thanks so much for having us. Hopefully, we have helped a lot of people chatting today.

Dr. Sharp: All right, y’all. Thank you so [01:01:00] much for tuning into this episode. Always grateful to have you here. I hope that you take away some information that you can implement in your practice and in your life. Any resources that we mentioned during the episode will be listed in the show notes so make sure to check those out.

If you like what you hear on the podcast, I would be so grateful if you left a review on iTunes or Spotify or wherever you listen to your podcasts.

And if you’re a practice owner or aspiring practice owner, I’d invite you to check out The Testing Psychologist mastermind groups. I have mastermind groups at every stage of practice development; beginner, intermediate, and advanced. We have homework, we have accountability, we have support, we have resources. These groups are amazing. We do a lot of work and a lot of connecting. If that sounds interesting to you, you can check out the details at thetestingpsychologist.com/consulting. You can sign up for a pre-group phone call and we will chat and figure [01:02:00] out if a group could be a good fit for you. Thanks so much.

The information contained in this podcast and on The Testing Psychologist website is intended for informational and educational purposes only. Nothing in this podcast or on the website is intended to be a substitute for 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 [01:03:00] 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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[00:00:00] Dr. Sharp: Hello, everyone. Welcome to The Testing Psychologist podcast. I’m your host, Dr. Jeremy Sharp, licensed psychologist, group practice owner, and private practice coach.

Many of y’all know that I have been using TherapyNotes as our practice EHR for over 10 years now. I’ve looked at others and I just keep coming back to TherapyNotes because they do it all. If you’re interested in an EHR for your practice, you can get two free months of TherapyNotes by going to thetestingpsychologist.com/therapynotes and enter the code “testing”.

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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/products/spectra.

[00:01:00] Hey, folks. Welcome back to The Testing Psychologist podcast. I have a fantastic guest for us today. Jana Parker is a licensed educational psychologist and the founder of Mind by Design, a multidisciplinary group practice in Campbell, California, offering psychoeducational evaluations, therapeutic services, and educational support.

She is also the owner of Empower LEP, which we are talking about today, an initiative that includes a podcast and online platform designed to inspire and educate licensed educational psychologists and school psychologists who are transitioning from public education to private practice in California and beyond.

Through her work, Jana provides practical guidance, encouragement, and inspiration to professionals making that career shift while fostering access to high-quality services for children, teens, young adults, and parents. Jana’s got a lot going on.

Today, we’re tackling this topic of licensed educational psychologists and the ways that Jana is empowering them. I think this is very [00:02:00] relevant for folks out there who are considering an LEP licensure, for school psychologists who are considering making the leap in a private practice.

We talk about the ins and outs of that process. We talk about the unique needs of those folks and the support that they need and many other things. This is action-packed and pretty informative. So if you are an individual who’s considering a private practice, especially in California as an LEP, this is the episode for you.

Without further ado, here’s my conversation with Jana Parker from Empower LEP.

Jana, hey, welcome to the podcast.

Jana: Thanks so much for having me. I’m excited.

Dr. Sharp: Likewise. I was glad to get an introduction through a mutual friend, [00:03:00] Scott Robson, who we all love. I’m excited for this conversation. You’ve got a unique little niche going on there with working with LEPs. So we will dive deep into that, but first I will start with a question that I always start with, which is, why this? Why spend your life in this pursuit?

Jana: Gosh, I feel like you’re talking about two things:

1. What is the pursuit of my actual life’s work with my practice?

2. Why am I doing Empower LEP? Why am I running that? You want to know the answer to both?

Dr. Sharp: Yeah. They both occupy a good bit of your time.

Jana: All right. I’m out here in California. I was always a certainty kind of person. [00:04:00] Taking it back to childhood, I loved dancing. I was a dancer. I just wanted to perform. So I was very into that, but I also realized that that might not be a good choice for a life career. And so I was always very into people and why people do what they do.

I always knew I would be a psychology major, but I don’t know why I thought that, but it was just always something I was into. And then I thought, I shouldn’t be a dancer. I should be a psychologist and then my parents said, “If you don’t go to graduate school right away, you’re never going to go back. So you might as well go.” And so I started a Clinical PsyD program and just thought, “Wait a second, I actually don’t want to be a therapist, this is not what I want to do.” I was introduced to school psychology while I was in that program.

So I [00:05:00] quit the graduate program and thought, okay, school psychologists, it’s like trade school for psychology. You know exactly what you’re going to do when you finish and that’s really what I wanted. I always wanted something where I was like, I’m great. I’m going to have a school job. I’m going to work 8:00 AM to 3:00 PM. I’m going to have weekends off. I’m not going to have to work holidays. What a great schedule. I’ll have a pension and benefits. And that felt good and secure to me. And then, lo and behold, I’m an entrepreneur.

Dr. Sharp: Isn’t that wild how it just creeps up on you?

Jana: Yeah. I never thought that I would be here, but what I realized about myself as I was going through my career as a school psychologist is I was not the kind of person who was going to be in one place and have a lifetime career in one school district. There are many people who feel very good about that and I just realized I [00:06:00] wasn’t that.

So every two years, I found a different job. I wanted to work with a different population; preschool, high school, elementary, and post-secondary. I wanted to try a lot of different things within the field. I also felt like once I came into a school and cleaned up shop, I got a little bored and I needed to move on to the next challenge.

And so I realized I had more of an entrepreneurial spirit than I had anticipated. I got lucky and ventured out into the private practice world because I was offered an opportunity to work at a private practice clinic that was run by a doctor.

In California, and this is something for your listeners in California, there is something called licensed [00:07:00] educational psychologist. I always knew as a school psychologist that I would go get that license just because I wanted to have it in my back pocket, and I think a lot of people do that, but I didn’t know that I was going to have the opportunity that I got to work in a practice and not even have to work at finding a way to use that license.

I can go into that a bit more too, but I learned about private practice working at this clinic. I was like, I really want to have a multidisciplinary clinic because as a school psychologist, I felt like I loved having a school team of multidisciplinary educators that I could consult with, assess with, refer [00:08:00] to. I loved that collaboration that we had.

And so that’s what I decided I wanted to do. And so 10 years later, I own a group practice, a small multidisciplinary practice in California. We have educational psychologists, speech pathologists, special educators and tutors. My dream is coming true with that.

And then I was offered to take over this group called Empower LEP. I was approached to do that because I was doing the work of the LEP, which is a specialist-level license. So you can be a master’s level, or specialist-level psychologist in California and have this license, or you can have a doctorate. A lot of us out [00:09:00] here just got our master’s because that’s the most popular graduate school program for school psychology in California is a master’s level program. So most of us out here have a master’s degree.

Most of us never thought that we would go into private practice because it’s so nice to just work for a school district and for so many reasons but I was offered the takeover of this business called Empower LEP, which was a perfect blend of my tenant; performer, dancer, coach. I taught aerobics forever. I was a personal trainer. I love leading and coaching people.

As we as school psychologists are thinking about making a transition into private practice; it’s a huge transition since we’ve worked in a system for so long, and we feel [00:10:00] so golden handcuffs, solid in that system. And so I thought, yeah, I really want to help guide people through this journey into figuring out what it is they want to do outside of the system, whether it’s a little bit or a lot. And so I run Empower LEP with all my free time.

Dr. Sharp: And with all the free time, huh? That’s the entrepreneur’s curse, is that there’s always time for something else. There’s always time. As you tell your story, it strikes me how we have so many paths to do what we like to do. You’ve had this thread of coaching, teaching, leading, and so forth. And that seems like it was present since you were younger. I feel like it’s a matter of time before some of those [00:11:00] skills emerge again. We’re lucky that we can do it in all these different ways with our degrees and our expertise.

Jana: Absolutely. I think that’s one of the powerful and incredible parts of us as people in the mental health and helping professions. Everybody is different. We bring pieces of ourselves to the work that we do. Everybody’s different. It’s not cut and dry or there is no script, we use the strengths that we have to support the kids and the families that we serve as well as the other professionals that we support.

Dr. Sharp: Right. You said a lot of interesting things. There’s a lot of threads to pull on here. The first one, let’s define licensed educational psychologists. What is this and where does it fall in the grand scheme of [00:12:00] licensure? How does it compare to a clinical psychologist, a school psychologist or a master’s level therapist? What is this licensure that y’all have in California?

Jana: Great question. I think that there are some other states that have something similar, but I can’t speak very informatively about that. So I won’t. But I do think that there are some other states that have a license similar. In California it was back in 1970, which is a long time ago, I’m surprised.

Dr. Sharp: It used to not be a long time ago, but all of a sudden now it’s a long time ago.

Jana: Right. I’m surprised that California was forging ahead with a license like this in 1970. It was born out of the need for more [00:13:00] educationally related mental health support for kids outside of the school system. It’s through the Board of Behavioral Sciences, which is the Allied Mental Health Professionals Board in California. So just like it’s a Licensed Marriage and Family Therapist in California for counseling and therapy, the same board has the licensed educational psychologist license.

What it allows for is educationally related services that includes assessments, consultation, advocacy, psychological counseling, anything that’s related to education. [00:14:00] There are several things that we do in my practice, for example, we do psychoeducational evaluation, we do school neuropsychological evaluation for those of us who have gone and gotten extra certification.

We do a lot of parent coaching. I call it a Tier 1 advocacy, so we don’t do advocacy, but because we have this unique school psychology experience, we have a lot of insight into special education law, how things go in schools. Parents often have questions about educationally related things; whether they need help at home getting their kids to do their homework or they’re not understanding what their paperwork at school means, how do they navigate this whole special education system? Is that even the right place for them?

So we can do a lot of [00:15:00] work with families around educationally related questions. I love it. What I found to be the biggest difference between an evaluation that we’re doing in a school versus an evaluation that we’re doing in private practice is that in schools were answering the special education question, is the student eligible or not? In private practice, we’re answering the questions that the families have about their kids related to their education and then whatever else we recommend as well.

Back to your question, we can diagnose out of the DSM, but we’re really looking at the conditions that arise out of the evaluations that we’re doing that are focused on education, but then also looking at how it affects other areas of their [00:16:00] life. So we end up diagnosing the more common things that we’re seeing at schools like ADHD, autism spectrum, learning disabilities, mood, anxiety, depression, developmental disorders, behavioral things.

And in schools, we saw all of that and couldn’t diagnose it. We saw it, we knew it, we would have to say something like appear to have characteristics consistent with ADHD, but we couldn’t say ADHD. In private practice, you can be more transparent with families about what it is, and what they should do about it, and you don’t have the barriers that you had at schools.

Dr. Sharp: That’s great. I’m curious, do the programs specifically track you for an LEP or is that something that you arrive at on your [00:17:00] own? I’m just curious, so it’s a master’s level licensure. You said there’s some doctoral level clinicians that get this licensure as well or did I misunderstand?

Jana: Yeah. You don’t have to be a licensed psychologist. For example, Liz Angoff. Liz Angoff is a PhD and she’s a licensed educational psychologist. She’s amazing, doing amazing things and she’s not a licensed psychologist. There are also some Ph.D.s because, in California, there aren’t that many PhD programs for school psychology, whereas on the East Coast, it’s mostly PhD programs, it seems like.

So we have a lot of master’s level people out here. We do 2 years plus an internship. So it’s a 3-year specialist level degree and [00:18:00] credential. And then you have to have several years of experience as a school psychologist. So you have to have 3 years in school and then you have to take a big exam before becoming a licensed educational psychologist.

So there are requirements. So there’s not a track, but any school psychologist who has the right education, training and supervision can apply and sit for licensure. And so that’s part of what empower LEP helps people do is pass that test.

Dr. Sharp: Yes. That’s a big hoop.

Jana: Yeah, but it’s just like the first two. It’s the most boring hoop; pass the test and then it’s all the rest of figuring out. Back to your question, how do you know how to do it? How do you know how to all of a sudden be in private practice, either seeing private [00:19:00] clients? Or we do a lot of IEEs. So we do a lot of independent educational evaluations.

In fact, in California, there’s Case law that supports having only educational psychologists doing these IEEs. So there are some school districts out here who will not allow for a clinical psychologist or a licensed psychologist to do the evaluation. It has to be a school psychologist or a licensed educational psychologist because they want something similar to what they would get in the educational setting.

I lost my train of thought. Oh, the question is, how do you do it? How do you figure that out? And that’s a big question and a big reason why people don’t do it. It’s a bit like the Wild West. [00:20:00] I will say that since COVID, more and more school psychologists are feeling burnt out.

Dr. Sharp: I can see that.

Jana: Working for schools is getting much harder. People are starting to like the LEP. When I got my LEP and when I was working with the board on some of the test development, this was many years ago, they said the LEP is the most underutilized license of the Board of Behavioral Sciences because people would get the license, but then never do anything with it because they were working in schools and it’s hard to do something different.

Dr. Sharp: What is the typical track? Do most folks who get the LEP just go back to work in the schools and it’s just an extra credential or do most of them go to private practice or do they go somewhere else?

Jana: Most of them are [00:21:00] still working in schools and just have it in their back pocket, but it does require 36 hours of continuing education every three years. There are significant professional development requirements, which of course takes money. So keeping up your license is expensive, but also thank goodness, we have that requirement because I think we should always be continuing with that learning curve. Most people just sit on it.

I think that since COVID-19, in the past two years, there’s been a significant increase in people hungry for change or something different. And so it’s been the perfect time for me to take over and revamp Empower LEP as a community to be a support and a resource for people who are thinking about either making the shift completely or making it even a little bit.

Dr. Sharp: Right. We talked a little bit about this, but [00:22:00] I would love to hear what you think are the unique challenges that face this group as they are going into private practice.

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All right, let’s get back to the podcast.

Jana: Gosh, so many. I would say the biggest one is fear. It’s fear of the unknown. It’s fear of that uncertainty. It’s self-doubt. It’s not trusting that they’re going to be able to do it. And also fear of the unknown, that it’s easy to be in a school job for the consistency and all of the perks that come along with it. You know where your next [00:25:00] paycheck is coming from. You know you’re going to have a pension when you retire. You know you have a good benefits package.

You just know that you’re going to get paid the same amount all the time, and then you’re going to get little incremental raises, hopefully every year. So it’s easy. When people think about doing something different, I don’t know about you but I was not taught anything about business, so there’s a whole lot to learn in terms of business logistics. You do mentoring and coaching like this too, there’s all of that and then there’s also this huge clinical piece. So how do you learn how to do that?

I got super fortunate because I got hired into a multidisciplinary practice run by a developmental pediatrician. We had other LEPs working alongside me. I had a doctor, I had nurse practitioners, I had other mental health professionals, I had people to [00:26:00] learn from, and people to consult on my cases and supervise me, as I learned, because …

Dr. Sharp: That’s so helpful.

Jana: I knew what I was seeing, and I knew what that was in schools, but that transition into taking what I knew I was seeing and turning it into answering these families’ questions using my assessment data to answer the questions and using so much more than just the numbers that are going to establish eligibility, but looking at the process of what kids were going through while they were doing these assessments with me in my office, like talking to their teachers and trying to conceptualize cases to answer questions rather than just establish eligibility, that was hard. It felt like a lot of pressure, like oh my gosh, I’m going to give this kid a clinical diagnosis.

So I felt fortunate to work alongside people who were helping me do [00:27:00] that. And that’s what I do for my team here at my practice, but that’s also what I do now at Empower LEP, because a lot of these people are going out and doing things on their own, and it is a lot to learn.

And if they’re not going to be part of a practice and they are going to do it on their own, I think they should reach out for help and they do.

I think the biggest pieces of why they wouldn’t or the pain points of people, as they are considering this change, are internal self-doubt, learning how to run a business, and learning how to think and use assessment data in a more clinical manner than they have been in schools.

Dr. Sharp: That makes sense. I think all those things are relevant for a lot of us as we jump into private [00:28:00] practice. It seems like there’s this added layer, I’ve consulted with two folks over the years who are masters-level psychologists and we do have to cross a big gap of how do you market your services and be competitive with doctoral-level clinicians. Because for better or for worse, there is a bias of sorts, folks want a “doctor”. And so I’m curious, do you run into that and how do you work through that when you’re offering a similar service without what seems like an equivalent credential?

Jana: That’s a great question. I talk to people who are calling all the time, and I talk to people who are trying to learn how to explain their services. I think there’s a lot of imposter syndrome that comes along with this because we do feel [00:29:00] like, oh, am I lesser because I only have a master’s degree? Should I go get my doctorate right now?

I take it back to myself, look, I have gone through so much professional development. I wish that I had made a decision about licensure earlier in my career. It’s just not going to happen right now. So I’ve got to be confident and know that I may not have a doctorate and I may not be a licensed psychologist, but I have a lot of experience. I’ve done a lot of professional development and my experience as an educational psychologist is in schools. It’s in the trenches.

I have seen it all. I have been in it all. We as school psychologists need to know how powerful that is and how unique that experience is. I always say, look, everybody has a [00:30:00] different kind of experience and training that leads them to how they’re conceptualizing cases, how they’re supporting families. There’s no right or wrong, better or worse, it’s just different.

So when parents call me, I’m not focused on what other people might do, I’m focused on the fact that if this feels like a referral that’s coming in because the parent is concerned about their kid at school, I am the best person for that. That’s how I feel. I know other people are probably really great too, but I have to internalize that. That’s my messaging for myself to help me have the confidence. I’ve been there. I’ve been in schools. I know what happens. I can talk to the teachers.

Most of the time, I don’t even need to do an observation. I know by just getting on the phone with that teacher and talking about that actual experience, and I know what [00:31:00] the behavior with me might look like in a classroom. We have this very specialized lens in which to look at these cases through, and that’s what I talk to parents about.

That’s what sets us apart. It’s different but that different does not mean lesser. Different just means this is my lens through an educational lens and then the rest. It’s not like we don’t give recommendations for what parents can do at home but if the referral question is, it’s also like making recommendations like what does this kid need in order to function in an educational setting that I have so much experience working in? How is this realistically going to work?

I think that all the experience that we have as school psychologists really helps us if we stay in our [00:32:00] lane of what we know and refer out when it’s a different kind of case. If somebody just wants to know if their kid has anxiety or there’s some significant mental health thing going on, I’m going to refer out. There are some educational psychologists who may feel very comfortable with that, but that’s not what we do here with me.

I think it’s knowing what your scope is and where we fit in, feeling confident about that and how unique our specialization is, and referring out and knowing when to do that.

Dr. Sharp: That makes sense. Like any of us, we can only have so many areas of expertise. I would love to talk in more detail what Empower LEP actually does. You’ve touched on it and given us a little bit of an overview, but I know that you have a lot going on over [00:33:00] there, and I would love to hear more about it. What would you say are your main offerings, so to speak?

Jana: The mission for Empower LEP is to take people along this journey from school psychologist to private practitioner; whatever that means for them, because some people are never going to leave the schools, but that doesn’t mean they can’t do something on the side, part-time private practice. They may even just want to lead the schools, but do contracting work in different agencies for school districts.

There are so many possibilities. It starts there. It’s like, what are the possibilities? It’s building a community of collaboration and support of each other, and also providing that guidance in all of those [00:34:00] different areas that people get stuck. Those three areas; the self-doubt piece, we have mentorship for that. In fact, Scott has done mentorship for my group. He’s about to start another one.

That piece of it, I bring professionals in because I can’t teach everything myself. So I bring professionals in who specialize in different areas. So whether it’s business coaching, whether we’re doing the internal piece, whether we’re doing business logistics, whether we’re doing clinical case work, it’s a community that offers guidance and support in all of those areas because we don’t have to do it alone.

I say empower LEP is for educational psychologists, but it’s also for anybody who’s making a shift into private practice. My focus is on this unique [00:35:00] niche because there are some unique aspects to this that are different from doctoral level and licensed psychologists but there’s also a lot of similarities. I think the overarching message is you don’t have to do it alone. There is a community here for you.

Dr. Sharp: That’s so valuable. That’s the number one thing. I do coaching groups for folks and it’s such a draw to these groups. You probably hear this all the time too, but it’s just the, am I the only one thinking about this stuff? Is there anybody else out there who gets it; who understands my life and can help support me in this process? It’s so validating to have a group of people who are going through it together.

Jana: Absolutely. It’s always in progress. I want it to go faster than it has. I’m like, [00:36:00] focus on my practice, which you know is very time-consuming.

Dr. Sharp: Oh, sure.

Jana: I did not realize in running a group practice just how much of me that would take. I’m incrementally starting to try to pull myself away from the day-to-day business stuff. I still want to be a practicing clinician. I do still do that, but finding all the time and having to code switch in my head from okay, business, and now I see this kid and then business, and then, oh, now I see this kid and now I have this phone call, it’s a lot.

And so empower LEP, I would like it to be going faster, but I’m incrementally building as I go. I have a website. It’s empowerlep.com. I have two different courses versus passing the LEP exam. I have networking and business basics. [00:37:00] I’ve got mentorship opportunities in groups or individually.

I have a podcast, it’s the Empower LEP podcast. On that podcast, I’m focusing on people’s stories for inspiration. There are two different kinds of episodes I do. I do interviews with people hearing their story and the cool things they’re doing based on their own specialty areas. I interview people who are building communities online, building AI, people who went into research or test development, professors, and then other educational psychologists who are developing their practices in different ways.

I think that, for the audience, hearing people’s stories helps them go like, oh, wow, that’s [00:38:00] cool. I could do that. Because it’s important that we, as school psychologists, whether we stay in schools or leave, and for anybody in this profession, we have to keep our buckets full. I think that finding the things that light us up inside helps to fill those buckets.

So even if someone was going to stay as a full-time school psychologist, but just do a little something outside, maybe that something is the thing that’s going to keep them able to do the good work that they’re doing in the schools. We have to keep finding and following the thing that drives our internal purpose. So we do that on the podcast. I also do some solo episodes where I talk about things about business or our scope of practice or just things that come up.

The podcast has been a special thing to me that I have really enjoyed doing. I have a Facebook group; it’s the Empower LEP Facebook Group [00:39:00] that anybody’s welcome to join. That’s where we have the community. So that’s what Empower LEP is all about and what I have to offer.

Dr. Sharp: I’m biased, but podcasting and building a community is a pretty amazing thing to do so I can get on board with that. Congratulations.

Jana: Thank you. I’m definitely loving it. You’ve been a big inspiration too. I’ve been listening to you since probably 2019. I don’t know how I found out about you, but I’ve been listening for a long time and it’s been really helpful, everything that you’ve shared. So thank you.

Dr. Sharp: That’s incredible. Thanks.

Jana: You’re welcome.

Dr. Sharp: That means a lot. That’s super cool. I was going to ask you, if you had to boil it down, because I know there are folks out there who [00:40:00] are listening and hearing parts of themselves here, who’s the ideal person for Empower LEP? What are they doing with their lives? What are they thinking? What are they worried about? Who’s your target person?

Jana: It’s aspiring or practicing educational psychologists. It’s people who are anywhere from, I’m a school psychologist and I’m like, I don’t know, I need something more. What is it? Is it private practice? What is it? Just anybody who is searching for a bucket filler in their career and not thinking about leaving the career per se, but what else can they do and how can they find that?

And then people who are already in it, people who are beginners, and then people who are farther into it. How do I [00:41:00] do this? I’m thinking about changing such and such. I’m not sure about this next phase I’m going into because there aren’t that many of us doing this out here but I think that whether you’re in California or anywhere across the nation, we all are having questions about both business and clinical practice all the time. So it’s people who are in any phase and people who are just starting to think about it.

One of the things that I wanted to share with the listeners is that I have a downloadable, it’s called My Why, which is a little bit cheesy, but also that’s the whole beginning. It’s about figuring out from a lot of different perspectives why you would want to do something different and what that could possibly be. And so it’s a workbook [00:42:00] that takes people through that journey.

It helps to uncover those deeply personal and professional motivations so that they can grow, whether it’s themselves, they want to do group practice, or they want to do something online, what is it? And so I wanted to offer it to your listeners. They just have to go to empowerlep.com/jeremy. They can get the workbook for free.

Dr. Sharp: Nice. We’ll make sure to put in the show notes.

Jana: Awesome. I’m eager to connect with people too. I can be found at jana@empowerlep.com. People can connect with me. They can join the Facebook group, Empower LEP Facebook group, and listen to the podcast because I love podcasting. I love hearing people’s stories, and I love talking to the community, even though a lot of times I feel like I’m just talking to myself, but the feedback that I get has been really great. I’m looking forward to hopefully growing that a bit more too.

[00:43:00] Dr. Sharp: That sounds great. Hopefully, folks go check out the podcast. I’ll be on there sometime soon. We’ll see.

Jana: Yes. I’m excited for that.

Dr. Sharp: It will be a lot of fun to turn the tables and have a happy little conversation.

Jana: Absolutely. I’ll put you in the hot seat.

Dr. Sharp: Yeah. Oh my gosh. I’m just coming off testifying this morning, so even hearing you say that I’m like, maybe not. Maybe we’ll put that off for a little.

Jana: We’ll wait a little bit.

Dr. Sharp: Podcasts are a lot of fun. Jana, thanks so much for coming on. This is a lot of fun. It’s good to connect with you. You got a fantastic resource out there for folks who really need it so hopefully folks will reach out.

Jana: Yeah. Thank you so much for having me.

Dr. Sharp: All right, y’all. Thank you so much for tuning into this episode. Always grateful to have you here. I hope that you take away some information that you can implement in your practice and in your life. Any resources that we mentioned during the episode will be listed in the show notes so make sure to check those out.

If you like what you hear on the podcast, I would be so grateful if you left a review on iTunes [00:44:00] or Spotify or wherever you listen to your podcasts.

And if you’re a practice owner or aspiring practice owner, I’d invite you to check out The Testing Psychologist mastermind groups. I have mastermind groups at every stage of practice development; beginner, intermediate, and advanced. We have homework, we have accountability, we have support, we have resources. These groups are amazing. We do a lot of work and a lot of connecting. If that sounds interesting to you, you can check out the details at thetestingpsychologist.com/consulting. You can sign up for a pre-group phone call and we will chat and figure out if a group could be a good fit for you. Thanks so much.

[00:45:00] The information contained in this podcast and on The Testing Psychologist website are intended for informational and educational purposes only. Nothing in this podcast or on the website is intended to be a substitute for professional, psychological, psychiatric, or medical advice, diagnosi,s 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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