[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 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. 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 podcast.
Today is an interview with a fascinating individual, Keith Kurlander. He is an LPC. He has his master’s degree. He’s the Co-Founder of the Integrative Psychiatry Institute which specializes in integrative mental health and psychedelic therapy education. Keith also co-hosts the Higher Practice Podcast for Optimal Mental Health and co-founded the Integrative Psychiatry Centers, a clinic transforming mental healthcare with innovative treatments. With over 20 years of experience as a psychotherapist and coach, Keith’s mental health journey began after a near-suicide at 19 following a psilocybin experience. Now a successful entrepreneur, he’s dedicated to teaching methods that help eradicate mental illness and unlock potential.
As you can tell, Keith’s experience comes from a very personal and meaningful place. He talks with me today about the journey through these different [00:02:00] stages of practice and of life. We talk about how to transition from being a solo practitioner into more of an entrepreneur or group practice owner into podcast host, and we eventually end up talking about influence and what an influencer role might look like for a mental health practitioner.
There’s a lot to take away from this episode. Keith has experienced many things that I think a lot of us probably aspire to or think about. I think that you can grab a lot of good info from our discussion today.
Before we jump to that, I will invite any of you who might want some support with your businesses to check out The Testing Psychologist Mastermind Groups. In January, new cohorts are going to be starting for [00:03:00] beginner, intermediate, and advanced practice owners. These groups are all about accountability and support. So if that sounds interesting, you can go to thetestingpsychologist.com/consulting and schedule a pre-group call.
All right, folks, let’s get to my conversation with Keith Kurlander.
Keith. Hey, welcome to the podcast.
Keith: Thanks for having me.
Dr. Sharp: Glad to have you here. I’m excited to chat with you. You’ve had a lot of experience in mental health, outside of mental health, and adjacent to mental health, and I think it’ll be interesting to a lot of our listeners. I will open with a question that I always open with, which is, of all the things that you could [00:04:00] spend your time and energy doing, I guess it’s a little different, why this, why now for you? You’ve done a lot of different things over the years. So why this? Why now?
Keith: I’ve always had a strong passion for helping people who are suffering and making the world a little bit better if I can while I’m here. And so, that’s been my whole life, at least my adult life. It’s just led to this. The different things I’m doing with the Institute, having people get trained in a more robust mental health care framework and understanding why we suffer, I just want to help out a little bit if I can. I think now, we’re in a mental health crisis. It’s not getting better. It’s getting [00:05:00] worse. If you look at the data, it’s pretty bad over the last 10 years and worse over the last 5 years. So I think the now is, it’s getting way worse for kids than ever before, for sure, teenagers specifically. I would say that’s the why now.
Dr. Sharp: It is pretty startling when you look at it. I don’t know if you have kids, but I have 2 kids, one is a tween, one is a teenager, and it’s getting very real all of a sudden, whereas before it was a lot more theoretical when they were little.
Keith: I have little kids. I’ve got a 9-month-old and a 6-year-old. I’m new at it in some ways, but it’s real. Teens mental health, it’s rugged out there.
Dr. Sharp: Right. There’s a lot to say about [00:06:00] that. We may dive into that.
Keith: That’s a whole thing, but…
Dr. Sharp: That’s a whole other thing. I read the bio before we dove into the interview here, but I think it’s interesting, I would love for you to describe a little bit, your journey over the last several years, because you have touched the mental health world in a lot of different ways and venues. I think it’d be interesting for folks to hear about that. That might be a good place to start.
Keith: Cool. I’ll go quick. I’ll go from my adult life very quickly to now because it’s all related. I started more as a yoga teacher, massage therapist, then became a psychotherapist. I went to Naropa University, studied Transpersonal Psychotherapy. Then I started a company. I’m leaving out some details, but then I started [00:07:00] a company around helping people build practices. Then a podcast that was broader than that, just around mental health optimization. Then transitioned, I’d say, which is now going on 6 years to what I’m doing now, which is the Integrative Psychiatry Institute and a host of other organizations that work together which is a Continuing Education Institute. We’re mainly focused on psychedelic therapy, but we’re teaching people about an expanded spectrum of root causes of mental health. So that brings me to now.
Dr. Sharp: Yes. And lots of details along the way, but we’re going to dig into some of those, I think.
Keith: Yes.
Dr. Sharp: We’ve got more of a business framework for our discussion today. I’m really interested in the early part of that description where you made the decision to expand outside of [00:08:00] one-to-one care or even practice ownership, maybe that’s the place that we can start, and decided to do things outside of that realm, which is where most of us get, I don’t want to say get stuck, but that’s where we land and tend to stay.
Keith: It works for a lot of people. And then for some people, it feels stuck. They want to change. For some people. I was one of those people where I felt, I didn’t feel stuck, I felt limited by the reach I had is what happened for me. I also felt limited by the salary. It was both. You can only make so much on a one-to-one model. I was having a kid and I was like, we need more.
And so, it was either, build a group practice to make [00:09:00] more but I also had the issue of I felt limited. I wanted more reach. I wanted to help more people than whatever the number I was helping in a year. That was great. I felt like I was doing great work. So I had a two fold process happening for me. I needed to earn more for my family, and I needed to reach more people, and so, where I went with that first was where I could help more people as if I help the people who are helping them, which is what I’m still doing actually. It was that way. And so that was around if I can help people have successful practices, they’re going to help more people, and if I can help a lot of people have more successful practices, they’re going to help a lot more people. And so that’s where I went with it at first. I still was a therapist during that time [00:10:00] period when I was doing that. That’s how it kicked off for me of okay, I need to do something different here.
Dr. Sharp: Sure. How did you pick the, because it sounds like the podcast was your first leap into the…
Keith: The first leap was not to the podcast. The first leap was was an e-course helping people. This was now 13, that may not be a full 13 years ago, maybe 9 years ago, was an e-course on how to build your practice. First, it was live, so I was doing a live cohort model of taking people through a process in e-course, and then I also did it, I think self-paced self-study. So I was doing digital education first and then the podcast came soon thereafter [00:11:00] as another avenue to reach people.
Dr. Sharp: I like that. I think a lot of people are probably interested in that path and how to do it, and it’s hard to really know how to do it. There’s not, especially back then, I’m sure there wasn’t a blueprint. I still don’t feel like there’s really a blueprint. How did you decide to go with e courses first and the in person component, was it local? Was it national? I’m just curious about building an audience for something like that and how to even sell that when you’re “just a practitioner.”
Keith: It was online. I went and studied digital course marketing and that’s a thing. There’s a lot of that going on. Back then there were a handful. 10 years ago, there were a handful of of the no names. There’s a lot more now. But some of those people still [00:12:00] are the big names in the space of how you create a digital course and sell it and all that. But I sold it through Facebook advertising. That’s a very typical thing you can do. You don’t need to be…
The space is a little different now. It definitely is more influencer driven now than it was then. There is that difference now, but either way, you can still create these funnels where you’re giving away things and you’re attracting an audience to an email list and then you’re sending them material value and then you have a course and get them into a course and that kind of thing. So yeah, it was going fine. It was a great run of reaching people, helping them with their practices, for me. I learned a lot in that time [00:13:00] period.
Dr. Sharp: Okay. It’s hard not to follow that lead. What do you feel like you learned through that process?
Keith: I learned a lot about people want and don’t want in terms of online education. I learned some of the things that work well and some of the things that don’t work well. I learned a lot about, I think in building private practices people tend to come into it not recognizing it’s a business. They don’t necessarily think of it as a business in the traditional sense, especially when we’re solopreneurs. When you’re growing a clinic or a group practice, I think most people think of that as a business model, but as solopreneurs, a lot of people [00:14:00] get into it. They don’t necessarily think of it as a business. They think of it as their therapy practice. There’s some roadblocks there in terms of trying to have an organization helping people with a business because they don’t necessarily think of it as a business. I learned that pretty quickly. But then there’s people that do think of it as a business and want to really get good at the business aspect of running a practice.
I would say, generally speaking, the people in solo private practice want to get good at being a practitioner. Many of them don’t necessarily want to get good at building a business. That’s not their focus. It’s not a bad thing. It’s just their values are more about the art of mastery over the technique, which is important. I’ve shifted my focus to the technique because [00:15:00] I actually, think it’s super important. That’s probably the most important thing. We have to have a lot of good people out there helping people.
Dr. Sharp: I agree. It does feel hard for folks to jump on board with being business owners, at least in the beginning. And if it doesn’t come naturally, that can be quite a process.
Keith: Yes. It’s hard because you have to confront when you really want to take on the mission of like I’m going to get good at running a business. I’m going to take that on. You have to confront in yourself your perceived ability to succeed or fail. Once you confront that, it’s like now you’ve got look at yourself of like, here’s where I’m afraid. Here’s where I have doubt. Here’s where I have low confidence. [00:16:00] Here’s my strengths. Here’s my limitations. What am I going to do about my limitations in business?
Most people that get into counseling, they’re naturally pretty good at the counseling part. And if they take the training, they get it, that technique and there’s naturally good at that part because that’s where their values are. But when we get into business now, we’re getting into things that haven’t necessarily been there on their values, their whole life, aren’t their values, so they may not be naturally good at that. So now you have to confront some things and that’s a hard road. It’s a great road. It’s an amazing growth road, but it’s a hard road.
Dr. Sharp: Agreed. I’ve had a lot of those moments over the years, I think, at different stages of practice and the other businesses. It’s it is tough. It’s hard to do the hard things, right? It is is very vulnerable.
Keith: Yeah, it is. And you’re going to fail and you’re going to make mistakes. [00:17:00]That’s the thing. For people who like sports, it’s you’re going to train. You’re going to win. You’re going to lose. You can get injured. It takes a lot of determination. You keep going and you train more and you learn more and you got new skills. It’s determination.
Dr. Sharp: Yeah, it’s a good way to put it. Can you think of off the top of your head, any big, gosh, setbacks, I don’t know if you call them failures, along the way that you feel like afforded you more learning than others?
Keith: I don’t love debt.
Dr. Sharp: Me neither.
Keith: That’s my personality.
Dr. Sharp: We can agree on that.
Keith: Yeah, maybe most people don’t, but in the beginning, I took some debt on, and sometimes you got to do [00:18:00] that when you’re growing something. And that’s okay. Some big companies always have a huge debt and that’s just how they operate. That’s a whole different world, right? Our country has huge debt, so that’s not inherently a bad thing, but I don’t love debt in business. It’s very stressful for me.
I learned that early on. I took some debt on and it was stressful for me. I don’t relate to the earnings the same way when there’s debt there. I’m always tracking the debt more than the earnings. So that’s one thing for me, but there are reasons to take on debt. I’m not talking about like a mortgage. I’m just talking about loans or credit card debt in order to run a business for a while. [00:19:00] It’s just who I am. I really understood myself more and try and get into projects now that don’t require debt.
Dr. Sharp: I like that.
Keith: Just because of who I am.
Dr. Sharp: Well, I think that speaks to… people have different risk tolerances, maybe, or different characteristics of what feels okay and what doesn’t in business. I also don’t like debt. I will do whatever I can to avoid it and not have to use it to as leverage in the business, but some folks are totally okay with that. And it might be a different thing then.
Keith: Totally. Again, when you talk about large businesses, we’re we’re talking about small business models here, but when we talk about large business models, there’s always debt involved. Whether it’s someone else’s money or venture capital, there’s always debt.
[00:20:00] Dr. Sharp: It is fascinating to me how that works. I don’t know. You hear of businesses that are however many million dollars in debt or take on funding or whatever. Maybe you just get used to it over time and get desensitized.
Keith: It just gets normal.
Dr. Sharp: Yeah. You did the e-course thing. It sounds like that was pretty relatively successful. You learned some things along the way and then decided to launch the podcast after that. Is that right?
Keith: During owning that company, I launched the podcast. It was a part of it, but it was later. It was 2 to 3 years into it, maybe 2 years into it.
Dr. Sharp: Again, just curious about that process and decision making. How do you decide on a podcast as the next venture in this business?
Keith: I would say it was [00:21:00] partially not just a business decision. It was wanting to reach more people. All my business decisions are about reaching more people I could say. I’m not a money first mentality. Again, most people in this profession aren’t. I wanted to have more impact. I wanted to have a place to talk to people in our space. That was intriguing to me. I wanted to ask them the questions that I had in my head about… I wanted to ask Peter Levine, Gabor Maté, these people. I wanted to get in conversations and ask questions that were in my head. So that was a cool way to do it for me. So that’s how it came about getting into the podcast world.
Dr. Sharp: I got you. That’s what I always say. It’s my favorite part of the job because you get to call up [00:22:00] experts in any number of arenas, and then ask whatever’s on your mind. It’s the best thing in the world, man.
Keith: Yes. It’s fun.
Dr. Sharp: Sure. Did you end up monetizing the podcast at some point? I think people are always interested.
Keith: I did, but not through advertising. That first company is, I don’t have it anymore, but now at the institute, monetizing in the sense that a lot of people find our institute through the podcast. So it’s not directly monetized, which is usually in the form of paid ads, but it’s a fairly large podcast and a lot of people find our institute through it.
Dr. Sharp: Yeah. That was the route that I went as well. It took a long time [00:23:00] to nail down advertisers. I do have advertisers now, but initially, the podcast was a medium for folks to find me and hopefully reach out for consulting.
Keith: I think that’s a great model in this space. I know a lot of therapists that also do coaching They get their clients through podcasting. It’s a great model. You can really be successful there to get to do more high performance stuff. If you’re into that coaching world, it’s a great model to get those clients who are also willing to pay a lot more for that type of coaching. Podcasting works well for that. I know plenty of people doing it.
Dr. Sharp: Sure. It sounds like it’s [00:24:00] working for you too, even though you’re trying to draw in practitioners primarily. Is that right?
Keith: Yeah, I don’t coach anymore. I don’t work with individuals much anymore but our organization Integrative Psychiatry Institute has thousands of customers a year so we have to have a big reach to find those people so that they can get educated. So podcasting is one way that people know about us.
Dr. Sharp: Right. And your experience, it’s funny, the parallels, it’s like when folks are starting practices, it’s always, how do I get referrals and what does marketing look like? And then it’s the same thing at this level. What does the reach look like? What does the marketing look like? How do you get people into the funnel, so to speak? I’d be curious to hear, in addition to the podcast, you know what the other channels are to [00:25:00] to develop a business like this outside of one-to-one service.
Keith: Definitely paid advertising. That goes from solopreneurship to entrepreneurship. Paid advertising is very successful for individual therapists if you do it well to what we’re doing. We have ads across most paid ad channels, the larger ones, Google, Meta, Linkedin- we’ve tried. Linkedin is not a great place to advertise. I don’t recommend that.
Dr. Sharp: Good to know.
Keith: I don’t know a lot of people that are successful advertising there. We’ve done a lot of things. We do print media, so print mailers. We have affiliates that can reach out for us to [00:26:00] their communities. Building an email list is very important. It’s not done by any means. That would be a great thing to do, even in a local practice. If you can build an email list of a few thousand people in the local practice, that’s going to gain a lot of momentum for you. Of course, you have to be willing to send them things in your email list, but that’s the same on this level. We have to give people valuable educational content, and that’s the same again, in private practice or running a company. We need to give people value so that they want to stay connected to us.
Dr. Sharp: Right. I just want to get your perspective. You’ve [00:27:00] been in the game for a long time at this point. It seems like historically, there’s this traditional model of, you create the funnel and you try to get people in opting into some kind of email give away or something or document or some helpful content. You get their email address. Then you send them helpful things, you nurture them. And then down the road, you have a nice email list to sell a higher ticket item or option or several options too. In your perspective, is that is that still the model that we’re working with? Have there been tweaks along the way or developments over recent years to that sort of basic funnel model?
Keith: That’s one model that still works, for sure. It definitely still is important and it works. Giving somebody, we call it lead magnet, we call it [00:28:00] a lead magnet because we’re magnetizing a lead right to ourselves, a lead being a future client or customer, depending on your business. That still works. And then nurturing them with educational content definitely works or non educational content. It could be you’re building an influencer platform and you’re nurturing them with entertainment. That’s another way to do it. That’s definitely one.
Now, the mediums of how that works has changed. You could do it through text. That’s always better, but harder to pull off. It’s not simple to do these things through texting because of the laws and people don’t like to give their phone number away whereas they don’t mind giving their email away. [00:29:00] So there’s there’s different ways to do it. But it’s still a basic formula of you want to draw someone into your world and then if you want to keep them in your world in terms of a model of how do you keep somebody that’s not ready to sign up with you or buy from you, you want to give them something over time that’s important to them that they can grow from. And so that still works great.
Dr. Sharp: That sounds good. Have you found anything over the years, you’re targeting practitioners mainly and trying to get folks to reach out, the content that practitioners seem to appreciate whether it’s educational or entertainment oriented, is there any way to draw themes?
Keith: I think practitioners, it depends on what. I also [00:30:00] have had to draw on clients because we also had a clinic for a long time, a larger group clinic. Practitioners want something specific that will make them a better practitioner if that’s what you’re wanting to give them. So if you want to give them that, then you got to focus in and narrow the lens and giving them things that differentiate you.
I think the key word is differentiation either way, whether it’s a client or a if it’s a practitioner, it’s about differentiation. You want to give them something that the next person isn’t offering them. That’s unique to yourself. You want to be unique to yourself because or else you’re going to get bored very quick. You’re not going to stay determined and persistent if it’s not unique to you. [00:31:00] It’s harder to, I should say. Some people can, but it’s harder to.
So, if you’re giving them something unique, that is really honest inside of who you are, then you’re throwing out the net to the people who want that unique thing. That’s what you’re trying to catch in that net. You don’t want people that want something else. And then you you want to stay focused in that way, whatever that offering is. Maybe you’re a depression expert and you love working with people who are depressed and there’s a way you do it that’s different than the next person. It’s like you want to just keep focus there. And then the depressed person who is drawn to your way will find you and then it’s a good match because they’re drawn to your way.
Dr. Sharp: Right. I don’t know about you. [00:32:00] That seems like one of the hardest parts of this folks; finding the unique voice, so to speak. I feel like it’s a crowded space. There’s a lot of Brené Brown quotes on social media. That kind of vibe. I think people have a hard time finding that whatever is unique or maybe they’re worried or maybe they’re scared to put it out there. Was there any kind of process for you around what kind of content do we generate? What is personal to me? I’m interested to hear how you went through that, if you did.
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All right, let’s get back to the podcast.
[00:35:00]Keith: I probably have more pride than shame. Some people have more shame than pride and some people have more pride than shame. In my case, I probably have more pride than shame that I identify with. I think we all have it in there. So for me, because of that, like putting it out there isn’t as scary for me. There’s ways to work with when you have more shame than pride. You have to do some things to to get yourself out there.
In terms of putting myself out there, not that scary for me. In terms of what to put out there, again I’m focused on, it was a natural development. As an individual therapist, I narrowed into a few things that I put out there and I ended up going down the coaching route eventually toward the end of my practice. So [00:36:00] then I started more marketing myself as a coach. I focused on a few things and I narrowed it more to disorder language and disorders, but for me, I focused more on how I was different with technique.
And then now it’s different. Running a larger company, our whole model is unique. We’re framing our whole model as an integrative therapy model. And so we’re focused on root causes and in the educational space, many people aren’t doing that. Interestingly, they’re focused a lot on techniques. We focus on techniques with psychedelic therapy and some other things, but our whole thing is about [00:37:00] disrupting the assessment approach to mental health disorders and looking at root causes.
Mostly, the assessment approach to mental health disorders, looking at a diagnosis, you want to get to a diagnosis and we’re like, that’s fine. That can help. But we’re way more focused on what caused the problem than labeling you with what your problem is. So it’s different now in terms of differentiation, but I didn’t approach it like, how am I going to differentiate? I never approached it that way in my head. And I don’t think that’s a good way to approach it. I think all you have to do is be like, who am I? And now you’re differentiating. The more yourself, you’re differentiated. No, there’s no other human like you. So I’ve always approached it that way of just I just need to be myself. What is that?
Dr. Sharp: I find that’s an easier said than done [00:38:00] situation for a lot of people. Just know yourself. I get it. I totally agree. I think a lot of people have a hard time with that. Who am I?
Keith: I think there’s a process to get to what that is, but I think that’s a better approach and question. It’s a better route of questioning than like, how can you differentiate from the next person? I always want to start with self versus other personally in the business world.
Dr. Sharp: That’s fair. You said something earlier which really resonated. It’s worth saying again. It’s if you’re not in alignment with yourself and what you like and what you enjoy, it’s going to get old really fast and then you’re going to burn out or get bored or whatever it is. “If you don’t know who you are”, you may just be able to use those guardrails to determine who you are. It’s [00:39:00] what do you not like? What does not feel good?
Keith: That’s fine. That’s a starting point. You can also work with people and go through a process to know more about yourself and you’re just going to be more… It’s going to be easier. It’s easier to become successful through a professional personal discovery. I think it’s easier to become successful that way, especially in a helping profession. There’s other professions maybe that’s not true, but I think in a helping profession, it’s pretty true.
Dr. Sharp: It makes sense. I’m going to take a little detour for a second. This is an assessment focus podcast, so I’m not going to let this go when you’re talking about your assessment process on looking at root causes versus diagnostic info. Can you just talk a little bit more about that? What do you mean when you say you’re looking the assessment route?
Keith: I don’t mean disregard coming to a diagnosis, but what I mean by that is, I think we’ve… Diagnoses, first of all, we should talk about the history of diagnosis because that’ll lead to the answer. It’s not that old. The DSM late 40s and 50s mostly coming out of World War II, and the need to understand what labels more of what people were shell shock and what people were suffering from. We come up with the DSM and we really come up with some new language than we have before. There were like a handful of words we would throw around prior to that in the early part of that century hysteria and things like that. And so we come up with these new terms and depression [00:41:00] and anxiety, and they develop not for not that long. We’ve only had this mental health construct that we’re working with right now that we assume is like the gold. We assume the the world is is a sphere now, and it’s not flat. That’s not what we assume. This is what mental health illness is and it’s just not that old. These terms that we’re working with. These disorders that we’re arriving at in our assessments. 70 years is not that long.
So we have these constructs that are useful. I think it’s helped a lot with so many things from medication to treatment plans, educational plans. These things are very useful on one level. And when you look at the course now, coming forward to your [00:42:00] question, then what happens over the course really started in the 70s 80s, especially on managed healthcare kicked in heavily. We got very focused on the diagnosis over time. So we got very reductionistic in terms of what’s wrong with this person? What’s abnormal about this person? Abnormal psychology, abnormal psychiatry. So we got very reductionistic and got very focused on diagnosis. Managed care really push that where you had to come to a diagnosis very quickly. The proliferation of antidepressants went hand in hand with needing diagnoses and also other psychotropic meds. We needed to know which meds to give the person and diagnoses help that process, obviously.
So [00:43:00] this all happened, but while this happened, we got reductionistic in that the point of the clinical interview was to come to a diagnosis, which would then basically create a treatment plan, alongside of that, we lost focus on, but what’s really causing this person’s issues. We got so focused on the symptoms because diagnosis is about symptoms, right? You might ask in the clinical interview for an hour and a half some things about childhood and some things about, in our case, what we’re teaching, maybe you start asking some questions about their body and how their systems are working, when we got so focused, we lost sight of what’s really causing this person’s problems in their life? Let’s just focus hard on that. Let’s do a really thorough examination to understand the causes.
[00:44:00] And so that’s why I say, I think diagnosis is, to some degree, very helpful, but culture also went alongside of this process. I’m depressed. I’m anxious. I have PTSD. I have bipolar disorder. Culture followed alongside that process. And at a cultural level, now 1 in 4 people are on psychiatric medications. That’s an astounding number That’s a lot. There was like 300 million antidepressant prescriptions written last year. Big number. That includes refills, but it’s a big number.
I’m just saying that I don’t have an issue with meds. I’ve taken meds in my life before. I don’t have a problem with them, but I think [00:45:00] what we’ve done is largely culturally people now associate these disorders with a pill, it doesn’t even work that often properly because it doesn’t get to the root causes.
So what do we focus on? We’re really focusing on educating providers on a huge spectrum of root causes that could be causing these issues in a person’s life and trying to help people build systems so they can understand how these things fit together, what’s within their own scope to actually treat, what’s outside of their scope, so they actually know what’s going on and they can refer out. So that’s why I say we focus a little more on causes than diagnoses in terms of the assessment and why you’re doing the assessment. It’s not because the diagnoses aren’t helpful, but the diagnosis isn’t going to [00:46:00] solve a person’s problem is the issue.
Dr. Sharp: How does that look in practice when say clinicians are doing an initial assessment? If we’re not focused on symptoms, what are the questions look like? What do the topics look like?
Keith: We might be focused on some symptoms just to have a sense, but we’re also doing a much more expansive review of a lot of different causes. It’s not that we’re not looking at symptoms to come to a diagnosis. We are because we just want to understand the person’s suffering. The symptoms are useful to understand how they’re suffering and how we can relate to them around their suffering. But no, we’re looking at a number of things.
We want to definitely understand what’s happening in their body. And I think [00:47:00] that’s very overlooked in the psychotherapy space. It’s not as overlooked in the medical space, but there’s but I’ll explain in a minute, it’s also overlooked there. So we want to understand how their gut is doing; how they’re functioning there. We want to understand how their diet is and their nutrition. We want to look at other factors that are related like sleep. What’s their water intake like? We want to understand some other things. Have they explored looking at their hormones?
The thing is we could go so narrow, so fast and just miss something so obvious, and when they go take care of it, they have a gluten allergy, and they are 50% better as soon as they take care of their gluten allergy, or they’re pre-diabetic, and they’re suffering from a metabolic syndrome, essentially, all day. No matter how much therapy you’re going to do, they may feel depressed for [00:48:00] the rest of their life until they deal with that thing. 1 in 3 people in the United States is prediabetes and 80% of them don’t know it. These are the things that we don’t know. Most counselors don’t know these things. It’s not like we’re going to go treat some of these things, but we have to have the education to know some of the stuff.
And so it’s not just that. It’s everywhere from also expanding our understanding of the psychological factors. I think one thing that has been advanced in the last 5 to 7 years is our understanding of trauma inside the field, which is huge.
Dr. Sharp: Yes. I think that’s fair. That is one place I think that we as testing folks do relatively well. It is always diagnostically [00:49:00] focused, but we tend to do more in depth interviews. We’re looking at medical stuff and physiological components and have a little bit more time, I think, to spend with people, which is helpful.
Keith: Hopefully. That’s the whole point is you’re you’re going wide and thorough. I think that’s really true. And again the outcome of testing, let’s say it was teens. There’s some really good things that can come out of some of these diagnoses that are given and educational plans. These things are very important. You have to communicate in systems with simple language. You’re not going to go and tell a system like, oh, this person’s dealing with all these causes. You’ve got to go into a system and be like, here’s the thing. We know what we do with that. With that said, it’s harder because at the end of the day, we really [00:50:00] need a personalized approach to care. And that’s hard in a lot of different systems.
Dr. Sharp: I think we’re all working on that, man.
Keith: Yeah.
Dr. Sharp: I appreciate you taking this little detour. We can steer back to the business side of things, but this is all good.
Keith: That detour is fun. It’s really important. I think we have to keep having conversations in the field of mental health care of what are we doing? Let’s just try and take a step back. It is the way we’re approaching this. What’s not working, what’s working. Are we willing to look at… With the amount of treatment resistance, are we willing to take a step back in the rise in mental health issues? Are we willing to accept back and go what’s not working because we’re not knocking it out of the park as a industry of mental health care. We’re not knocking it out [00:51:00] of the park by any means.
Dr. Sharp: It’s true.
Keith: We’re limping along actually, when you look at how many people are not getting better.
Dr. Sharp: I know that’s a whole can of worms. There’s a lot to get into there, but I agree. I think we can agree on that. There’s a lot of room to do better.
Keith: There always will be.
Dr. Sharp: Yes.
Keith: It’s not like we’re doing anything wrong. It’s just, there’s always room to grow, right?
Dr. Sharp: Yeah. It’s a good way to put it.
Keith: But I think individual people, like someone listening to this podcast is like, how are you going to innovate? Because it’s not about waiting for a system to innovate. It’s like, how are you going to educate yourself? How are you going to innovate in your own sphere? We all have to innovate in order to keep growing and further our understanding of the problems and the [00:52:00] solutions.
Dr. Sharp: I like that. That maybe relates back to some of the stuff we were talking about in the first half, which is, you used this term influencer a couple of times. I would love to talk with you about that concept. What does that even mean to be an influencer in the mental health space? I’ll speak for myself. I hear influencer and I think of the Kardashians and whoever else, typically female individuals who are modeling something or using makeup or something. So I’m curious how you’re thinking about being an influencer in this space.
Keith: I think the term now is broad. The influencer industry is massive now. I don’t know if it’s in the trillions or hundreds of billions, but [00:53:00] it’s one of those two, meaning that individual people are creating a platform typically in social media where they gain followers and they influence them around something. It could be makeup, it could be anything, but it could also be about education. It could be about mental health. You would call Brené Brown an influencer. You would call Esther Perelson an influencer in mental health space? She has a large social following. She has a lot of content and social media and a lot of millions of followers. Those are larger influencers. You don’t have to be a large influencer to make a difference in the world. Also to grow your practice, you don’t need to be a large [00:54:00] influencer like that.
So that’s what I’m referring to. You grow a following that you have influence over. That’s the term. And then in this case, it would be that you have influence over people’s mental health. And hopefully, in this case, it’s in the positive direction. Obviously, it could be a negative influencer too.
Dr. Sharp: That makes sense. It’s rolled into this. All of this that we’re talking about is creating an ecosystem around you, your ideas, brand, if you want to think of it that way, personality and things like that.
Keith: Yeah, yourself, your brand.
Dr. Sharp: That seems a lot more relatable or doable than typical definition of influencer or early models of being an influencer. I think [00:55:00] some folks might have a hard time stepping into that role, but there’s a lot of room.
Keith: There are so many ways. First of all, you don’t have to do it that way. You can be very successful without doing that. In fact, most therapists are not influencers in terms of that definition. So you don’t have to do that. But if that attracts you… You would only want to do that if you’re drawn to it, because it’s not like… You could build a very successful group practice. You could build a very successful individual practice without ever being an influencer online. But if you’re drawn to it, then you can also, the market space gets wider if you’re drawn to it. It opens some new opportunities and it can be very fun and fulfilling to reach a lot of people that you can’t reach individually. You could go from reaching tens of people or hundreds of people to tens of [00:56:00] thousands, hundreds of thousands or millions of people that you have something to share that you want to share. And that could be very fulfilling.
Dr. Sharp: Yeah. Talking about reaching such a large audience, I think, again, people are always questioning how do I grow my audience on social media if I want to go this route. I wonder what has jumped out over the years as far as social media influencing
Keith: Mostly, I haven’t focused on… I’ve mostly grown our audience in podcasting and then internally through email lists building. I never went really big into social media specifically. We have some following in there, but it’s nothing huge. But in terms of social media, I [00:57:00] would say the thing is with social media, if you really want to become an Instagram…
First, you have to choose your channel. That’s the first thing. You can’t focus on all the channels. You have to choose the channel, and each channel has a different medium. YouTube is a little different than Instagram in terms of what is going to grow a following, different than TikTok, and different than LinkedIn. So you have to choose your playing field. And that depends on your personality type and what you want to do. For instance, in Instagram, you could do no videos. You could do just little cards with your own quotes on it. That wouldn’t work in YouTube. YouTube it’s a video platform. Instagram is highly video driven too, but you can do more things. It’s more versatile. So it just [00:58:00] depends on who you are and how you want to play there. What you want to be doing that kind of thing. TikTok, you’re going to be doing very short stuff. The algorithms are going to favor things that are extremely short reels.
Dr. Sharp: Absolutely. It makes me think about the gosh, how to frame it, power of choice or being deliberate, shiny object syndrome, all these things. I think people get overwhelmed with the possibilities and what we could do. It makes me think of the power of being deliberate and choosing what works for us.
Keith: Yeah, I agree with that. I think that’s super important. I totally agree with that. I think the other thing is not [00:59:00] getting hooked on seeing the shiny object, like look at what this person is doing and getting jealous or afraid you need to be like them. First of all, one thing you should know is you never know someone’s success by seeing them online. You’ve no idea what’s going on in their life.
Dr. Sharp: That’s such a good point.
Keith: You’re just projecting on them. They may actually be struggling in a lot of ways you’re not. And so that’s super important to remember.
And then I think you do have to come back to where are you? I always like taking the path of least resistance in my life. What’s natural for you for the next step? What comes easier to you for that next step? Don’t do the hardest thing as your next step. If going online is your next step, and it comes easy for you, you spend a lot of time online, you actually like it there, actually are already interacting with a [01:00:00] lot of people online, maybe that’s an easy next step for you; but you never go online, you’ve never commented on anything in your life, it’s probably going to be a really hard next step for you. There’s probably a better next step.
Dr. Sharp: I love that you said that. I’ve been thinking and acting a lot over the last several months around this idea of what would this look like if it were easy? What would this look like if it were joyful? I think it’s easy to get stuck in things that aren’t joyful and fulfilling. And there’s some mythology around running a business that it’s a grind and it needs to be hard. You got to persevere and all that kind of stuff. But I like that we’re touching on this, that path of least resistance is totally fine. If you enjoy something and it works and it fits into your business model, just do [01:01:00] it.
Keith: Yeah, path of least resistance and always in your values, like what’s most important to you because it’s just going to be, you have so much less resistance to doing the work if it’s important to you. But if you start taking on projects that you actually don’t find very meaningful, you’re going to be procrastinating a lot more. You’re going to have a lot of other reasons to go do that because the thing itself is not going to be the reason. I think things that are really important to you are going to be path of least resistance and then things that you really enjoy doing.
Dr. Sharp: I am with you. Good stuff.
Keith: And then, of course, whatever you choose to do as your next step, if you actually want it to be part of a business where you’re receiving something back for something you give in the form of money, you always want to make sure that the thing you’re giving has a [01:02:00] lot of value because when there’s a lot of value, you’re giving out, you’ll get a lot of value back.
Dr. Sharp: Right. It’s a good way to think of it. If you’re not 100% committed to something, people, I think are going to be able to tell.
Keith: Yeah. And if you don’t perceive your own value in what you’re giving out, you’re going to get back the level of value you perceive, and then if you have an inflated sense of value, then that’s a different issue. That’s a different problem. You might get an inflated sense back, but then you often get humbled too often if you’re inflated, but you will get back your perceived sense of value. And so a lot of people who are struggling in their careers with finances often haven’t really looked at fully is their perceived sense of value. They often don’t perceive a lot of [01:03:00] value that they’re giving out.
Dr. Sharp: It’s a good way to put it. Goodness.
Keith: That’s a whole different thing.
Dr. Sharp: That’s another thing. I know we’ve got so many threads, but this has been good. There’s so much to dive into with this business world. You’ve had a different experience in a lot of practitioners and different directions you’ve gone. So thanks for sharing all this. If people want to chat with you or learn more about what you got going on, what’s the best way to find you or hear about it.
Keith: I think a few things. If you like podcasts, check out The Higher Practice Podcast. That’s a great place where we cover a large spectrum of just mental health stuff topics. And then our institute’s a great place to visit; psychiatryinstitute.com. Just check out the education we have on there. [01:04:00] There’s a lot of interesting things to learn from there. I think those are the two good places to keep it simple.
Dr. Sharp: Okay. Simple is good. I appreciate your time. It’s good to connect. We’re right down the road from each other.
Keith: I know. We’re around the corner.
Dr. Sharp: Yeah. Thanks for spending the time. I hope our paths cross again sometime.
Keith: Yeah. Thank you.
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.
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If you’re a practice owner or aspiring practice owner, I’d invite you to check out The Testing Psychologist mastermind groups. I have [01:05:00] 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.
The information contained in this podcast and on The Testing Psychologist website will are intended for informational and educational purposes only. Nothing in this podcast or on the website is [01:06:00] 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 area. Similarly, if you need supervision on clinical matters, please find a supervisor with expertise that fits your needs.
