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[00:00:00] Dr. Sharp: What’s going on, y’all? This is Dr. Jeremy Sharp. Welcome to The Testing Psychologist podcast, episode 8.

Welcome everybody to another episode of The Testing Psychologist podcast. I’m Dr. Jeremy Sharp. I am really excited to have you with me today, Joe Sanok. You may know of Joe from hosting the number one podcast for counselors and mental health practice consulting, the Practice of the Practice podcast.

Joe is also a speaker, a mental health counselor, and a business consultant. On his podcast, he has interviewed a number of very well-known, very cool guests, Pat Flynn, John Lee Dumas, Chris Ducker, Rob Bell, Glennon Doyle Melton, and Lewis Howes. Joe is also a writer. He’s written for Psych Central, Huffington Post, Reader’s Digest, Bustle, and Yahoo News. He also is a keynote speaker and has authored 5 books. Joe tends to talk about things like the DNA of the human brain, how to slow down to spark innovation, and seven practices of the practice- how to set, achieve and outsource ideas.

Joe, welcome to the podcast.

Joe: Jeremy, thank you so much for having me. This is great. 

Dr. Sharp: Yeah, absolutely. Thanks for coming on. 

Joe: Yeah, absolutely.

Dr. Sharp: I imagine you hear this a lot. I feel like I have known you for a long time because I’ve been listening to your podcast, but we have just been introduced over the last 6 or 8 months. I’ve been working with Joe on some consulting. It was interesting when I was looking around for a consultant, Joe, and interviewing folks, I kept coming back to you because we have these interesting connections that keep [00:02:00] popping up. One of them is that it seems like both of us had our first introduction to our wives via snowboarding. 

Joe: That’s awesome. I want to hear your snowboarding story.

Dr. Sharp: Well, my wife still tells the story about how we drove up. This was our first date. I picked her up at 5:00 in the morning. That was one thing just to start off. We were both bleary-eyed and kind of like, oh gosh, what do we do? So we drive two and a half hours up to the nearest mountain. We went to Keystone here in Colorado and it was snowing so badly all the way up, which is great for snowboarding, but not good for a conversation on a first date. So she’d still joke about how I am just like white-knuckling it in the car and trying to be cool and calm and do this date thing with her. 

Joe: That’s gutsy for both of you to go on a two-and-a-half-hour drive with a person on their first date. I think I would meet up and have my friend call me halfway through or something. So that’s amazing. 

Dr. Sharp: Right. Yeah, we just went for it. So, that was interesting. And we both had dreadlocks. Any number of things. So I’m excited to have you here.

Joe: Oh, I’m really excited to be here too. 

Dr. Sharp: Very cool. Joe, I wanted to start off and just talk with you a little bit about your practice. I know that you have recently hired a psychologist who does assessmentss for you. So I’d like to get to that. Just tell us a little bit about your practice and what you do as a director of your practice, and then we’ll go from there. 

Joe: I started in 2006 as a contractor for a small group or actually a pretty large group practice down in Kalamazoo, Michigan. And then in 2009, my wife and I moved back to our hometown of Traverse City, Michigan. I had filed an LLC when I was a contractor, and so, I just moved it up here. It was really just a side [00:04:00] gig to pay off student loan debt.

I was a foster care supervisor, I had this small practice going on the side, and then I got hired by a community college and I added 2 clinicians because I was so full that I couldn’t do it outside of that 40-hour job. And I had 3 other people working for me while I was still working my 40-hour-a-week job.

Over time, I started to look at my numbers and realized that in this 10 to 15 hours a week running this little side gig, I was making as much as I was in my 40 hour a week job. So about two years ago, I left that full-time job and really just decided that I wanted to do full-time practice.

In the summer, we got up to 11 people in the group practice. I haven’t looked back. It’s been such an amazing change for my life. I’ve slowed down in so many ways where I work 3 or 3.5 days a week and have 4-day weekends with my two little girls and my wife. it really for me has been such a positive health change and professional change, and the bottom line income has gone up as well. 

Dr. Sharp: That’s fantastic. There’s a lot to unpack there, I think, in what you said. Congratulations, of course, on growing your practice. It sounds like you have a lot going on. So, of those 11 clinicians, can you tell me how many are counselors? How many are psychologists? I know one does testing. Is that right?

Joe:  Yeah. This summer we peaked at 11. At that time, 2 of them were moonlighters where they’d see 5 or 6 people a week, and then other ones were aiming towards full-time or they were full-time. And so I was thinking, I actually want to downsize a little bit and just focus on a handful because when you get that big, everybody has opinions and I wasn’t really good with people telling me what to do.

So wait, actually, it naturally worked itself out where people moved. Actually, 4 of them moved and left in a really short period of time. The rest of the practice was like, what is happening? Everybody’s leaving. And it was for all legitimate reasons. They all left on really good terms.

So [00:06:00] now we’re actually down to 5 clinicians, which is actually been really nice to just invest in those 5. So I have 1 psychologist. I have 3 licensed professional counselors, 1 social worker, and then myself. I’m an LLP; a limited licensed psychologist in Michigan, and then I’m also a licensed professional counselor.

Dr. Sharp: Got you. I want to ask about the psychologist, of course. We talk a lot about testing here but I’m also curious just for you as a practice owner, how much are you actually doing counseling each week these days versus more administrative or testing stuff?

Joe: For me, I have really noticed a change for myself over the last two years. I have really being drawn to doing the consulting with people that own practices. And so, I would say that’s the big thing that I try to spend most of my time on. I only do 3 to 5 sessions a week now.

I bet I spend half an hour a week working on the actual practice and doing admin-type things. I’ve really outsourced a lot of that. I have right now 4 virtual assistants that do a variety of different things for me. And the more that I can take off my plate and really do the things that I do best, the easier it is for me to continue to level up in those areas of consulting, podcasting, and helping people grow their practices. 

Dr. Sharp: Sure. It sounds like you have really done a good job of slimming down, and like you said, slowing down, which I would love to talk about here later as we go along. That’s been a big focus for you over the last few months.

Before that though, let’s really dive into the psychologist part and the assessment part. How did you decide that you wanted to bring on a psychologist who focused on assessment? 

Joe: My dad, he is a PhD level psychologist. He worked in the schools and did assessments. Whenever it was Take Your Son to Work Day, I’d go with him and go to schools. I could never sit in on the assessments, but I would see what he [00:08:00] did.

In 2nd grade, I wrote a paper about why I wanted to be a psychologist when I grew up. And so for me being a psychologist, like I never wanted to be a firefighter or anything like that. I did want to be a railroad conductor at one point when I was a kid because we lived by a railroad for a little bit, but other than that, my whole life, it was just like, I’m going to go into counseling or psychology. And so it was never a question. It was more of how it fit my own personality.

And so when I launched the practice, I really had discovered that for me, personally, testing and assessments wasn’t something that I enjoyed. I think they’re awesome. They provide such valuable feedback, but it wasn’t where I personally wanted to spend my time.

But I was out for coffee with a friend of mine who is an attorney locally, and she was venting about how she was sending almost all of her custody evaluations down to Grand Rapids, which is two and a half hours south of here. So people would have to drive down there multiple times. They would have to bring their kids down and go through this assessment with someone that didn’t know their community and how she was just so frustrated by thsi.

I knew that I was going to be looking for someone that would come on and really aim to be full-time. And so, as I talked with this attorney more, I said, “Could you send me some custody evaluations that you’ve really liked with the names and everything redacted. I’m just getting a sense of what you like. And then maybe we can talk about what you’d want improved upon as I look for somebody that could join the practice?”

So really, the stars aligned when Dr. Marilyn Fitzgerald reached out to me and we started to talk and really she wanted to do custody evaluations. And as she met with this attorney, they talked through what would meet her needs as an attorney, and what would be best for a kid-focused custody, evaluation? What are the things that are really log jams in the system right now?

There were 2 people in Traverse City that were doing custody evaluations, but they often wouldn’t get the reports to the attorneys till two days before they went to court, which just isn’t enough time for the attorneys to really talk to their clients. And so, speed, quality, all of those were things [00:10:00] that Marilyn really focused on providing, especially because she wasn’t full at that point. And so it was easier for her to say, okay, I’m going to give this over-the-top customer service to attorneys and the families that I work with.

So for me, really helping her frame who she helps was what I did as a practice owner to market herself more for me to market her. And then she is reaching out to continue to get custody evaluations. 

Dr. Sharp: Gosh, you said a lot of important stuff in there. One thing that really jumped out to me is just the value of turning a report around pretty quickly. I think that just cuts across any discipline of testing. Having a quick report turnaround is so valuable to everyone. 

Joe: Yeah. And I think that even beyond just the reports, when you think about customer service, if you called your primary care doctor to schedule a new appointment, and then you had 4 or 5 phone calls back and forth, and you just couldn’t schedule it, you would get frustrated by that.

But in a lot of counseling practices, that’s the norm where you don’t have somebody that’s answering the phones and you feel like, well, until I have a really big practice, then I can afford to have somebody. But realistically now with virtual assistance and with your phone systems that can be forwarded to people’s cell phones, it’s really easy to have somebody just answer your phone so that you can schedule new appointments.

And so, I think at every level, we have to evaluate our speed and our quality that we’re giving so that we can stand out in our markets. So that’s going to be in the form of your tests, the test’s speed, just returning emails and phone calls. And if you don’t have the time to do that, having an assistant do that’s trained and obviously has signed a business associate agreement and all of that to be in compliance with HIPAA, but we have to level up what we do in regards to customer service on every level. And I think testing would just be one aspect of that.

Dr. Sharp: Yeah, I totally agree with you. And I’m gosh, somewhat ashamed to say that it took me a lot longer than it should have to bring on a full-time assistant here in the practice. But all I can say is that since we have done that, it has [00:12:00] revolutionized our practice even more. We were successful before that, but it has just been a huge leveling up. Clients are happier, things are running smoother. It’s super important. 

Joe: I can’t think of a situation unless someone’s getting zero phone calls that they’re not going to be cost positive. Jeremy, if you get a new evaluation for you or one of your clinicians, or if even a counselor gets someone that’s $100 an hour and they come for 10 sessions, that that phone call is worth $1000 to $5000 or $10,000 plus all the people that person would refer and talk positively. And so, how many hours of time would you have to pay for that person to make that up? I mean, they’re almost always cost positive where you’re spending less and you’re getting more. 

Dr. Sharp: Absolutely. I think for us, or at least personally, for me, a big hurdle in bringing on someone to answer the phone was not knowing if they would be able to describe testing services like I would, and I think just for anyone listening who might be considering that, it’s definitely trainable. My admin personnel honestly knows a lot about testing just over the past few months, from talking about the services on the phone with folks. 

Joe: Yeah. The rule of thumb that I’ve heard is that when you’re training someone to do something that you’ve done, you should expect to spend about 20 times, however long the task is. So if it’s a 10-minute task, it should take you about 200 minutes or so to teach them how to do that exactly like you. And when you hear that, you’re like, whoa, that is a ton of time for a 10-minute task, but you figure if they do it 20 times, and take that off your plate, then all of a sudden, you’re in the black bag again.

And so it’s not going to be where, oh my gosh, this was a big waste of time. Instead, it’s going to be, I trained somebody to take this off of my plate. Now, after that 200 minutes, I can do whatever I want with that time because they’ve taken it over and can do it as [00:14:00] well, if not better than how I did it.

Dr. Sharp: Yeah, for sure. And if you do the math, at least in our clinic, that 200 minutes sounds like a lot like, oh gosh, almost four hours, but that gets made up for us in like two days, maybe three days. So, a little bit of investment upfront and then good to go for the long run.

Joe: Right. And you think about what your hourly is when you’re doing an assessment, you’re the most overpaid person answering the phones and doing scheduling. And so, I think that’s just one area to say, how do we remove things off your plate so that you really can spark those big ideas inside of you?

Dr. Sharp: Yeah. I love that. Another thing that you said with regard to bringing on Dr. Fitzgerald was helping her get connected with folks in the community. I imagine that some of my listeners will be really interested in that if they were to join practices as testing psychologists. How did you support her and get her connected with other folks?

Joe: I think it starts with before you ever are bringing people on, making sure that you know what the value is that you’re bringing from the percent that you’re taking from people that are joining your practice. A lot of people will say I’m taking 35% or 50% or whatever’s appropriate in your community, but really making sure that that value goes beyond just I provide a space.

And so one thing that I’ve developed over time is these connections in the community. For example, every month I have an article in our local newspaper. Every other week, I’m on local radio. I have these different connections with like the Traverse City Business News or different magazines that are in our town where it’s easy for me to do a press release and get them coverage.

So right away, I invited Maryland to come onto WTCM-the Christal Frost show where I’m on there talking about pretty much anything I want that has to do with counseling or anything in the news that she wants to talk about. And so, I’ll send Christal an email and say, Hey, I have this new clinician, she does custody evaluations. I think we could talk about how to have a healthy divorce. We could talk about [00:16:00] divorce. We could talk about co-parenting. What kind of alliance with where your audience is right now?

And then Christal will email me back and say, oh, that sounds awesome. Let’s just talk about kids of divorce in general. I’m a kid of divorce and would love to chat about that and see what Marilyn says. So then, Dr. Marilyn Fitzgerald comes on the show with me. The first time that they go on the show, I’m always with them. And I encourage them to have show notes that they bring to the radio station with their main points to make the host sound smarter. And she goes through and she chats it up and does an amazing job.

And now I know that I can just be like, Hey, I don’t want to go to the radio. Marilyn, will you fill in for me? Yep. Okay. Sounds good. Now you’re on your own. You’ve been onboarded. I’ve done some training for you to be successful on radio, and now she can then go do that herself as well.

Dr. Sharp: I got you. It sounds like there are some, Gosh, what would you call it, just extra benefits to coming on board. It sounded like she knew that she would get some of those benefits and get to go out in the community when she joined your practice. 

Joe: Yeah. And I think that as a business owner, I want to always be making this, the premier place for people to refer for counseling, but I also want people that work here to say, he may take a higher cut than other people, but we love working here for these reasons.

It can be something as small as all their clients have access to., we have a refrigerator when people walk in that is full of Starbucks, frappuccinos, coconut water, and we have a team machine. We do all sorts of things to really make this feel like it’s an exclusive experience for people, no matter what their price point. They can be coming in and be a sliding fee. And we’re not going to say you can’t get coconut water.

No, we’re going to make everybody feel like they’re really special when they come here because they’re bringing their biggest issues in their life to us. What a gift for them to give us of giving that time and that hurt to us and saying, please help us. And so we want to really have that reflected in our branding, our customer service, and the way that our counselors feel about working here. 

Dr. Sharp: I think that’s so important. There’s [00:18:00] value built into working at your practice, it sounds like, and maybe, hopefully, some pride that comes along with working there too, knowing that they’re serving clients well, and it’s a nice environment and all those pieces. That’s great.

It’s interesting. I’ve hired a few folks over the last several months as we continue to grow. In the interview, I really emphasize with people. I ask, what do you really want to do here? And it’s been interesting to me how several people are kind of like, what do you mean? I’m going to do whatever I need to do to have a job, right? And I’m like, no, no, no, no, I want you to really like being here and really enjoy what you’re doing. And that’s almost like a foreign concept sometimes for clinicians to be catered to, I guess. 

Joe: Well, I recently interviewed Brian Canlis who’s one of the co-owners of Canlis restaurant in Seattle, which is oftentimes a James Beard nominated restaurant top five restaurants in America. And one thing that they ask in their interview is how is working at Canlis going to positively affect your life? And I just love that question as part of an interview where they’re looking to hire a person, not a role.

It may be that this is a one-year job, but it’s going to make them a better person in some way. And if they know that even in the interview, they can say, okay, we want to give you different leadership opportunities because we know where you’re headed, than if you just said, Hey, I just want to cook for your restaurant. 

Dr. Sharp: Absolutely. I love that. I think the takeaway, maybe from folks who are listening, if they’re testing psychologists looking at jobs in practices, is that maybe you can ask for some of these things and you can be a little choosy and look for a place that really takes care of you a little bit, right? 

Joe: Absolutely. And I think just like how you didn’t see a specific job you wanted in Fort Collins, you created a job through your private practice, or you didn’t see a podcast that was out there and so you launched a podcast that [00:20:00] would speak specifically to testing psychologists. And so for people that your community may not have this amazing practice, well, that’s an awesome opportunity for you to say, how do I create a practice that is the kind that I would love to have worked for but just didn’t happen to be here?

Dr. Sharp: Yeah, exactly. So, let me ask you, now you’ve had Dr. Fitzgerald on for a few months, right? Maybe several months in your practice. So can you speak a little bit, just to the value that you may have seen from adding a psychologist who can do testing? 

Joe: Yeah, I think that the value, what’s really great is we can now refer internally in a lot of ways that we wouldn’t in the past. Marilyn does counseling as well. And so she has the testing side, but she also does some clinical work as well, but she can say, we have clinicians here that can help with what I’m recommending. We can also refer outside of here.

To have these sorts of things all internal to say, we have a substance abuse counselor that does substance abuse assessments. We have a psychologist that’s doing custody evaluations. We have a counselor that does ages 0 to 7, and then we have one that does 7 to 18. And then we have 3 that are working with adults. So to be able to cover the spectrum in a number of ways makes it a lot easier for us to grow, not that we’re always going to refer to each other. We always have to look at who’s going to be the best fit in our community for a referral. And if we’re not, then we would obviously refer out. But to just be this one-stop-shop if people want to has been such a valuable thing to add.

And I think that also so often counseling or social work is viewed as this nebulous woo woo. You just come and talk. And having things like substance abuse assessments and custody evaluations, adds a little bit more science to it, a little more data to it, so that it really pulls in that feeling that we’re closer to the medical field than we are to like the social science fields. And I think that’s really important for a practice to continue to look at not just assessments, but [00:22:00] technology and ways that they’re going to try to genuinely provide the best quality services in your town. 

Dr. Sharp: Yeah, absolutely. Now have you noticed an uptick in phone calls and referrals since you brought her on just people being interested in this assessment?

Joe: Yeah. She’s by far been the fastest launch of a new clinician we’ve had. I have a new model for onboarding people where there’s a certain level of income they have to bring in in a month to move from being in an onboarding phase to being in a full clinician phase. She’s probably done that faster than any clinician that I brought on.

And part of that said, she really wanted to hustle. She really wanted to grow. And I think in her personality, she was at a point where she’s like, just bring on the clients. And so she was networking herself and she’s really connected with rotary and has a lot of connections in town. So I think part of it’s that just her personality fostered that, but then these custody evaluations are needed. And so that was an area that we did enough research on the front end that we knew that people were already referring down to Grand Rapids. So now they can stay up here.

Dr. Sharp: That’s fantastic. So have you noticed anything, I know you talked about just introducing her around and the radio show and things like that, have you noticed anything so far in your experience that’s been particularly helpful with regards to marketing testing services there in your community? 

Joe: I think connecting with the people that are going to make the referrals. It sounds so simple. But just like we sat down with that attorney, to continue to do that and get a gauge for what’s frustrating these people.

So, when we look to attract partners for mental wellness counseling, we want to find people that are going to be relieved that we’re offering a certain service. So that attorney who was sending her clients down to Grand Rapids, when we announced, Hey, we do custody evaluations, she’s going to be relieved for that. It’s not going to be marketing to her and trying to get her convinced. Instead, she’s going to say, thank goodness you [00:24:00] guys.

In the same way that if there is a doctor that didn’t have anyone that they knew that was a clinician that worked with eating disorders or girls that cut or whatever, as soon as that therapist starts offering that service and expertise, that doctor is going to fill you up right away.

And so for us really doing that front-end research in finding partners that are thrilled that we’re offering custody evaluations, I think was probably one of the biggest things we did that was able to help Marilyn be able to grow as quickly as she has. 

Dr. Sharp: Yeah, I think that’s so true. There’s often a need for testing in the community, but you sometimes have to search that out because it’s maybe a lesser known niche, I think, compared to therapy.

Joe: Yeah.

Dr. Sharp: Yeah, absolutely. 

Joe: Well, I even think about almost every medium-sized town may have a college, a community college, some sort of higher education within 50 miles or so of you. I’m sure there are spots where that’s not true. But when I worked at the community college, if someone had had an IEP or a 504 plan in high school, that didn’t automatically move over into college.

And so oftentimes, the students, if they wanted accommodations, say they needed to have extra notes or have a note-taker in the class or have the seminars recorded, whatever the accommodation was, they had to oftentimes have a new psychological evaluation to confirm the diagnosis, even though they had had an IEP since kindergarten.

So even just connecting with your local community college and just talking with whoever’s in charge of disability services and just saying, I do testing, I’m looking to continue to develop this. How do you guys confirm diagnosis to be in alignment with the Americans with disabilities act? And they may say, oh, we, we don’t. And then they may then have some discussions over, are we going to have some liability here if we’re not confirming this diagnosis? Or maybe they have a very clear process. Finding out what for them do they need, do they need a really bulky one? Do they need [00:26:00] a quick diagnosis? What does that look like in your community? And what does that look like for you ethically?

In most communities, colleges are searching for people to do testing. I know for us at the college, to find somewhat affordable testing to confirm a diagnosis was often cost-prohibitive for our students. So if you’re just starting out, I think that would be a great place to receive some new referrals. 

Dr. Sharp: I think you’re right on. I especially like what you said about catering to referral sources and offering the evaluations that they need, but also balancing that of course, with ethics and what’s appropriate testing and that kind of thing.

Joe: Yeah.

Dr. Sharp: Switching gears a little bit. I wanted to talk with you. I know you’ve been doing a lot of work over the last several months around slowing down and taking things off your plate. I think this is really important for folks who do testing because we’re unique in that regard that half of an evaluation, give or take, is face-to-face, but then the other half is often scoring or writing the report, which is something that we can do out of the office. And so, where a lot of us I think get stuck is we fill our time and the office with face-to-face appointments and then end up with a ton of work to outside the office. And so, this value of slowing down and being really mindful of your time and how to keep that work-life balance is huge. So I wonder, could you talk about your process with that over the last few months? 

Joe: Yeah. So it was about a year ago, I did a podcast interview with this guy, Rob Bell, who went on tour with Oprah, and we were talking afterward about just lifestyle- how to continue to grow in our careers. And he had said, think through what you’re really good at. And if you were to turn that into, whether it’s a handout or a book, write it down somehow.

It was really hard for me to think about that. So I started asking some of my friends, what do you guys think I’m good at? What I kept hearing was you [00:28:00] tend to innovate a lot. And if there is a way you could teach people about how you innovate, that would be really helpful. And so then I’m like, well, how do I innovate? I don’t know how to do this. I don’t know this structured process. But then when I really started to zoom out from it, I realized that I had some pretty strong habits of slowing down.

Our best ideas usually come when we’re in the shower, we’re on a long drive, maybe it’s right before you fall asleep. It’s not usually when you’re on your Facebook feed or when you’re checking email that your brain goes, oh, I have this great idea. Usually, it’s that we’ve slowed down in some way.

And so I’ve created some habits in my own life. Like on Fridays, I stop between 12:00 and 17:00 depending on what I decided with my wife and our schedule to just totally be done with work. And so, I won’t check email. I won’t listen to podcasts. I won’t read business books. I won’t talk or brainstorm with my wife about business because she gets sick of it. As entrepreneurs, we’re excited about our businesses. We’re always thinking about them. And so then by Sunday I’ll have had usually two full days of just totally being with my family, with my friends, doing things that matter to me. 

And I’ve noticed that I go through three phases where the first phase is this purging phase where I go to pick up my phone and I go to click on Facebook or my email. And it’s like, wait, no, Joe, you’re taking a step back from your business. And so, I go through this purging phase and then we move into what I noticed was this practice phase, where when I do things, and that could be as simple as cleaning the house, going for a hike with my daughters or my wife. It could be having friends over and playing board games and making dinner with them. Some sort of practice that focuses me on the here and now versus on what I could be creating for my business.

And then what naturally seems to happen each weekend is I then get into this presence where, okay, I’m here. I’m excited about my family and these practices have really helped me to be centered on what’s most [00:30:00] important. So when I do that, what often happens is I have all these ideas that start coming out. And that’s where I’ve developed the seven practices of the practice of how to set, achieve and outsource goals. I don’t know if we have time to go into all that, but I’m happy to go into it or if you want me to just keep the big picture overview, I can do that too. 

Dr. Sharp:  Well, can you just touch on the seven practices of the practice and let us know what those are? We can go into more detail as it comes up.

Joe: Sure. So I like to think of goals as sort of like mountain. I’m a hiker. I love being outside. So the first three practices are more planning and getting into the goal. The middle three are all around just like achieving that goal. And then the last one is moving away from that goal and taking it off your plate so that you can move on to the next goal.

So the first three are evaluate what’s worked in the past. You often hear that 20% of what you’ve done gets you 80% of the results. So doing time studies. Looking at what’s really bringing in the clients. What are the referral sources that you should foster and maybe the other ones that you should move away from spending as much time on.

So then moving into the second step is to define. Define whether you’re starting something brand new. Are you launching a brand new podcast like Jeremy did or are you amplifying something established, like adding clinicians to your practice when you already have a thriving testing practice?

So then after you’ve evaluated and defined, then moving into planning, looking at what success within a year would look like, and then breaking that down for this month, what would be a big step for this month? And then this week, this day, and breaking it down into micro-moments so that if you’re stuck at a coffee shop and a friend is running late, you can do something that’s going to keep moving that needle forward, where you’re using your best time to take steps forward. So, evaluate, defined, plan is the way up.

Then once you’re at the top of that mountain, the next step is usually creating content. So this could be copy for your website. It could be blog posts. It could be a podcast. It is offering something to show your ideal client or your ideal person for whatever this goal is that you know what you’re [00:32:00] talking about. That you are an expert in that area. You’re growing expert in that area. And then you want to move into that attracting partners. We already talked about that, where you find people that are thrilled that you’re doing whatever this goal is, so that they’re going to refer people to you.

So then we’re onto that last one, which is over-serving, which I already talked about a little bit to where we start to get busy, we start to maybe get more clients and then we aren’t returning phone calls or we aren’t filling the refrigerator with frappuccino. You want to make sure you sustain that over-serving where people get way more than they expected. And they’re surprised by how well they’re served. So we’ve then achieved the goal.

And then the very last step, and this is the one that most entrepreneurs miss is outsourcing. And I think at the beginning of the interview, we talked about this too, where we fill our plates, our brains go wild when we achieve goals. We’re so excited. We have this release of energy inside of our body. And then often we move on to that next goal and really quickly, we then are overwhelmed and we get all that stress on top of all of those sparks of innovation that could come out and you need to be outsourcing as much of your goals that you’ve achieved as possible.

So getting an assistant that’s going to answer your phone, is going to refill your refrigerator, going to do all those things that you don’t have to be doing so that you can move on to that next, really big idea. 

Dr. Sharp: Yes. Goodness, how to summarize all of that. That was a lot of good info in a really short period of time. I don’t want to speak for everybody who does testing, but I think as a group, we gravitate toward structured, planned out, data-driven kind of stuff. So the fact that you, it sounds like, have really thought through these and laid them out in specific steps is really attractive, at least to me. 

Joe: Yeah. And I have three videos that I go deeper into talking about specifically how do you do that because for me, I like to learn and go back to things and think about it and pause it. And sometimes it’s hard when it’s just like, boom, here are the steps. So I go more in-depth on the seven practices and then how [00:34:00] to slow down.  And I can give you that link for the show notes for people. 

Dr. Sharp: Yeah. We’d love that. I think that’s maybe a nice segue actually to, you know, if people want to learn more about your consulting, which I can totally vouch for, Joe’s an amazing consultant and has really helped grow our practice here. If people want to reach out to you and learn more about consulting or slowing down or these seven practices, what’s the best way to get in touch with you? 

Joe: For consulting, I’d say, go to practiceofthepractice.com/consulting. There’s a whole page that has testimonials from people, talks about what the packages look like, and how the typical packages are. I only do catered consulting approaches where I talk to people and then decide with them what would be the best steps forward. If people want to get those three videos, they can get those at practiceofthepractice.com/slowdownvideo.

And then this summer, I’m launching a conference that’s called the Slowdown School and that’s just at slowdownschool.com where we’re going to spend a week together slowing down and then sparking innovation and then taking those big ideas and putting some meat on them. And then we’re going to go wine tasting.

Dr. Sharp: Well, that’s ought to be.

Joe: Yeah, I know. It’s going to be awesome. 

Dr. Sharp: That sounds like a good weekend. Well, that’s awesome. Thank you.

Before we wrap up, any words of wisdom, anything you wanted to share with folks, specifically folks who are doing testing, maybe building a practice or looking to join a practice?

Joe: I think for testing psychologists, because you’ve gone through grad school, you’ve written amazing reports, you’re trained to do everything at an A-plus level. It’s really easy to feel paralyzed by perfection. And so, I would say it’s more important to take small steps in the right direction in an imperfect way than to get paralyzed and not do something because you don’t want to do it wrong. I think that’s really natural specifically for psychologists with testing, because you need to do good reports. You need to have them look awesome. But in moving forward in whatever your goals are, step away from that being paralyzed by perfection and just get some things done.

Dr. Sharp: That’s great advice. I think that really will resonate with folks who do testing. You nailed it there.  

Joe: Thank you so much, Jeremy.

Dr. Sharp: Thank you, Joe. Take care.

All right, everybody. Thanks so much for listening to that interview with Joe Sanok, host of the Practice of the Practice podcast, and one of the top mental health consultants here in the country. Joe gave us a lot of good information. I’ll have a lot of links in the show notes to all the cool stuff that he mentioned.

As always, thank you for listening. And if you haven’t already, please do me a huge favor, take 30 seconds and go into iTunes or wherever you might be listening to the podcast and hit that subscribe button. If you feel so inclined, I’d love if you gave us a rating or even wrote a review. I really appreciate it.

If you are looking to take some pretty concrete steps to really build your testing practice, you can go to thetestingpsychologist.com/fourweekblueprint and sign up for the email course that’ll give you an email each week with pretty concrete action steps that have the intention of building your assessment practice within four weeks. So that’s there on the website. I also got plenty of blog articles and resources there.

If you want to connect with other testing psychologists or mental health practitioners, come check out our community at Facebook. You can search in the Facebook search bar or go to thetestingpsychologist.com/community.

So, thanks again for listening. Keep tuning in. I’ve got some really cool interviews coming up. Next time, I think I’ll be talking with Dr. Amy Connery at Colorado [00:38:00] Children’s hospital about transitioning in and out of private practice, having a private practice on the side, and performance validity testing in kids. So, I hope to see you next time. Thanks. Take care.

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[00:00:00] Dr. Sharp: Hey, everybody. Welcome to The Testing Psychologist podcast, episode 7.

Welcome everybody to another episode of The Testing Psychologist podcast. I’m Dr. Jeremy Sharp. Today I am talking with Jen Knopp, a counselor here in Fort Collins, Colorado, and a longtime friend of mine. Jen and I have known each other for probably going on five years now. We were in the same consultation group for many years and got to know each other there through our clinical work. And that gradually shifted over the years to where we do work together here clinically, but I would say our main interest is our shared love for running.

I will put in a little plug for Jen. She is an amazing runner. She’s going to Boston here in the spring for the second time in a row. So a little congratulations there. 

Jen: Aww, thank you. 

Dr. Sharp: Of course, I have to give props to another runner. But what we’re here to talk about is assessment, of course. I wanted to talk with Jen because she has been a therapist here in our community for several years. We have shared several clients back and forth. She is a therapist here in town who I think really values the process of assessment and the value for her therapeutic clients.

We’re going to talk about a lot of things assessment-related primarily from the therapy side. So, Jen is going to have a conversation with me today to address some of those pieces. But before we dive into that, let me do a little bit more of an official bio for Jen, [00:02:00] just to let you know who she is and what she does.

Jen earned her undergraduate degree in psychology with a minor in sociology and her master’s degree in counseling psychology from Saint Martin’s University. She moved to Colorado in 2009 and opened her own private practice, Freedom First Counseling. She also works a large portion of her time at, Beyond the Mirror, a local agency that specializes in disordered eating, wellness, and self-esteem for adolescents and young adults. There at Beyond the Mirror, Jen serves as the Assistant Director and one of the primary therapists at the agency.

Jen, that’s just a little introduction. Is there anything else you’d like to add about your professional work or your personal life that people should know about you? 

Jen: Well, I moved to Colorado here in 2009. I’ve really enjoyed opening my private practice and being able to work with Beyond the Mirror. In private practice, it’s pretty unique in that you get a lot of benefits of being able to be flexible and have a really open schedule, but one of the challenges is that it can be isolating. And so, being a part of Beyond the Mirror and being able to connect and consult groups and with teams and with you Jeremy has been really helpful because it helps us feel like we can really serve our clients even if we’re not in a clinical setting, like a community mental health that we can really work with everyone.

And so having done a lot of those different types of jobs in the past, working in the schools and working at residential places, I felt that it’s really helpful what we have here in Fort Collins to be able to work together individually, but as a team too. 

Dr. Sharp: Sure. I think that’s a really good point that private practice can be isolating and we’re [00:04:00] fortunate enough to live in a community where we think have a pretty good connection with the other therapist here in town and are able to collaborate on services pretty often.

Jen: Absolutely. And I do have to put a plug that Jeremy you’re part of why I actually have made it to Boston and been able to do that. So also that may be something you may or may not know about Dr. Sharp, but he is quite the impressive runner as well. 

Dr. Sharp: I haven’t talked much about running here on the podcast, so maybe that’s something that I’ll get into from time to time, but yes, Jen and I have done a fair amount of training together, and always a good time.

Thank you for that little introduction and a little bit more information about you. Like I said, Jen, I just wanted to have the opportunity to pick your brain as a therapist who appears to value assessment and evaluation in your work with clients, and just have a conversation with you about what assessment looks like from the therapy side and some things that are helpful, not so helpful. And we’ll just see where the conversation goes. 

Jen: Yeah, that sounds great. 

Dr. Sharp: Okay, cool. Well, so I think one of my first questions is as a therapist, what is running through your mind when you’re working with clients that maybe lets you know that that person could be appropriate to refer for an assessment? How do you know that?

Jen: That’s a really good question. I think that in the settings that I’ve worked in before, a lot of the clients had had an assessment before they had even come to me.

What’s very different in private practice is that I may get a client that has had a lot of counseling before, I may get a client that this is their first session that they’ve ever come and they’ve never done any counseling before. And so [00:06:00] that’s going to really have an impact on the amount of information that they know, and then the insight that they have and what they’ve tried, or if we’re starting fresh and new.

And so, on one hand, I think that there’s really not a bad time for an assessment and that actually most of my clients could benefit from them because it gives so much more information.  And the more information we know as therapists and the more information the clients know about themselves, we’re going to be able to treat them more effectively, more efficiently, more fluidly, and help meet a lot of their needs.

More commonly, I would say where I find myself referring or having that question come up is when, I have a client who maybe they’ve done a lot of different types of therapy, whether that’s with me, I’ve used a lot of different strategies or they’ve already done that in the past and they’ve struggled consistently. And while they may or may not have something identified as going on, like, all right, this is definitely anxiety, or this is definitely a mood disorder or this, they may have heard a lot of that language or even been diagnosed in the past, but it seems like a lot of the standardized treatments have not been successful in really matching what they need.

And so that may be the case for me individually too and working with them, where I have all of these tools and I have a pretty good idea of what’s going on, but something is missing. There’s a piece to the puzzle missing that’s interfering with our treatment and our effectiveness. And that’s a really difficult process for the client to go through and also for me as a therapist.

And so at that time, it becomes pretty crucial for us to get a different perspective to see what’s missing. Whether we’re also needing to see that may be impacting this that’s not showing up in therapy or that we haven’t identified yet. And so, that’s probably one of the more common times that I would [00:08:00] refer.

Dr. Sharp: I got you. I certainly would consider you a fairly seasoned clinician who has a pretty big range of interventions and good clinical sense about your clients, but it sounds like maybe there are some times when you get to the place where it feels like there’s something missing or the client has had some varying diagnoses over the years and you might need to supplement that or clarify things to guide the treatment. Is that right?

Jen: Yeah, absolutely. And I think that there are certain things that I would say I’m really specialized in. And so, I’m familiar with how all of the different ways or many of the different ways that that can present, but that there’s other areas or other components that may come in that I’m not as trained on, or I don’t have as much expertise on or hasn’t really shown up in that way.

And so, we as therapists, are working day in and day out with the client and we’re doing our own assessments consistently, but we’re also dealing with whatever’s coming in the room at the moment. And so, it’s a lot of moving parts. And in that, I think that it gives us a really unique perspective of the client and we would know them really well, but it can also possibly make us miss something because we’re in it and dealing with all of the pieces at the same time.

I get a pretty good sense of, wow there’s just something that either I don’t think is really right, or as far as the diagnosis or the treatment that we’re doing, something feels like it’s really not effective. Or maybe I don’t know at all, or maybe I have a hunch of what it is, but it really isn’t in an area that I know a lot about. So I want to know what’s going on, what referrals do we need to make and how can I be more effective. 

Dr. Sharp: I got you. Sure. That really makes sense. It’s interesting. I think the two processes, [00:10:00] therapy versus assessment are a good match because each addresses the flip side of the other, right? Like you have a really good working knowledge of your client and sort of that long-term sense of what might be going on for them. And then, an assessment can jump in.

I really like dropping into someone’s life for a pretty short period of time, but have it be really focused and look at these really specific pieces of functioning and then use that to integrate with what you already know about them and supplement the work that you’re doing with them.

Jen: Yeah. And I think that is really helpful because knowing them or not knowing them is really going to be… you can’t have that knowledge in the other perspective without being able to come in fresh. And so, that fresh set of eyes. And then in addition to that, I don’t do testing as a therapist. And I don’t do the same types of assessments. And so, the expertise that you have and what you’re able to do at your center is very different in what it can provide. And so that is another piece that’s really helpful for me. 

Dr. Sharp: Cool. Yeah, I’ve talked on here before about one of the things that I really like about testing is getting to know people in a fairly intimate way, but it’s a very different intimacy than happens with therapy, right?

Jen: Yeah.

Dr. Sharp: Yeah, hopefully, complementary services.

Jen: Yeah.

Dr. Sharp: I was curious also when you do refer someone for an assessment, what are you hoping for in terms of outcome or recommendations or what you take away from that assessment when it comes back to you? 

Jen: I think when I refer, there are a couple of different areas that I’m looking for. Myself as a therapist, I’m looking to understand the client more [00:12:00] fully to see what all pieces may be impacting the symptoms or what’s going on. What are some of those underlying things that maybe are going to help me be able to support the person moving forward, but also what recommendations do you have based on that that are going to help guide my treatment planning or help guide the team that I am trying to put in place to support the client? What referrals, what kinds of things in that way are going to come from that.

And then for the client, my main goal is, I talk about it in an exciting way, like this is a super helpful to know what ways in which you think, what is going to be some of your strengths, what are going to naturally be some of your challenges, all of us have these things.

And so this isn’t something where the purpose is to go and gain a label. That’s just so we have a common language to be able to discuss things, but that it’s really about finding out about yourself more deeply, which can really help come over some of the barriers that are happening in their lives or help bring in the support for some of the things that maybe they don’t know, aren’t things that they can necessarily change, but there are things that they can be more effective in addressing and gain skills in.

And so, I think that both of those sides. And then also for the families, I think that that’s a big part that it’s helpful in too is educating the families and support people around them. 

Dr. Sharp: So, you really got into something that I wanted to ask you about, which is how do you talk with clients about an assessment when you’re making that referral? And maybe there is a difference. Maybe you could speak to this, if there’s a difference between how you talk with parents about the referral versus how you would talk with a young adult you would refer to assessment. 

Jen: Sure. And I think that part definitely depends on the person. I think some of my clients are more [00:14:00] interested in it or maybe excited about it, whereas others feel really tentative to do it, or they don’t want to, or they’re having no clue what it really is. And so, it’s that feeling of like anxious and is something wrong with me. Do you think something’s wrong? It’s going to be another thing, that I’m going to feel shameful about?

And so, I think part of it with clients because of their level of vulnerability and where they’re at any given point and their openness to it, I’m talking to them about what it is; what our real goals are, not, Hey, this is the exact test that’s going to happen, and this is how it’s going to go, but more in the sense of how it’s going to help them, how it’s going to serve them, how it’s really about gaining information so that we can help support them moving forward. That it’s just as much also for me to be able to confidently be able to lead them in a direction that they want to go.

And I think that’s one of the most difficult parts in therapy when we don’t have something accurate, like a diagnosis or some of those underlying things is that I see clients feel a sense of hopelessness. Like this is never going to get better. I’ve tried all of these things. And while there may be a lot of reasons for that, I think that there are a lot of times where it’s because we don’t know something and that when they’re able to find that, there is a greater sense of hope for them. 

Dr. Sharp: Yeah. I was curious about that. That got me thinking. I work with kids primarily, so I talk with parents a lot about the pros and cons of having a “diagnosis or a label.” I wonder, do your clients bring that up much with you? The pluses and minuses of that label or the diagnostic process. How do they talk about that? 

Jen: I think it is definitely client-dependent. [00:16:00] I have a good portion of clients who they really want to know. When they find out what is going on in terms of an actual label, their life can begin to make sense, like all of these different parts that maybe they felt like I struggled in every area, but they’re seeing the reason that I struggle in every other area simplifies it in a way, or at least validates, this is a thing, this isn’t just something that I’m not trying hard enough or I’m not doing that.

On the other hand, I think people, some of my clients that have had a lot of therapy and maybe throughout the years, and that they have gotten a lot of diagnoses or they’ve heard a lot of that language or that it’s been talked to them in a negative way like something that wrong, like always trying to figure out what’s wrong with you, that can be really damaging. And so then with those clients, I really talk about the purpose of it to how it too. How that really isn’t what we’re looking for.

Parents, a lot of times, I notice at least with the clients who I work with, are a little bit more concerned about how the diagnosis is going to impact their child in the future. Are they going to be labeled on everything? How is this going to impact them? And I’ll get a lot of those questions when I talk about referring too. 

Dr. Sharp: Got you. So just for my own curiosity, I’m curious how you frame that for them when they voice those concerns. 

Jen: The parents?

Dr. Sharp: Yeah.

Jen: I validate them in saying that, of course, there is stigma out there. There are impacts. I understand where they’re coming from and I understand their concerns. And I explain to them a lot about the confidentiality process, and really again, why we’re doing this in the first place is [00:18:00] that we’re looking at, if we don’t know what’s really going on, we’re going to constantly be feeling the struggle, and that it’s going to serve them rather than hurt them in getting what they need. And that the assessment is a lot about gaining information. They can choose what they do with that information. I think knowledge is power in that way.  

Dr. Sharp: I like that. I like the way that you say that they are able to choose what they do with the information.

There are some rare cases that I run into, I think about court-ordered stuff, mostly where the parents or the individual, they’re obligated to release the report to someone else, but in the vast majority of the cases, that’s not true. And so, I take the approach of, let’s present them with all of this information and talk through it and try to present it in a healthy way, and then it really is their choice what they do with it. And I’ve just given them the tools to, well, to work with, and then they can take it where they want to take it. 

Jen: Right. And I think, that’s a big part of therapy in general or moving towards goals is that, we try and do the best we can to identify what we’re seeing and be able to provide what we can, and that they really are going to choose what to use and how to utilize that.

Dr. Sharp: Sure. I was also curious, I think I’m switching gears more to I’d say the practical or logistic parts of the assessment, but I’m curious for you what makes a useful report?

Jen: That’s a great question because I think, in the past, I don’t think I knew really a lot about what was even in a psychological evaluation. Working in the settings I did before, I may connect with the psychologist and get an overview, look at it, [00:20:00] but I really have learned a lot since being in private practice and since connecting a lot more with psychologists in the community for me to know what the benefits are and what ways that that can serve me.

And so, I think in the actual report part, the recommendations are such a huge part for me because we are in the depth of everything with the client and working through so many different pieces that I think it helps me to step back and see, it could be a very simple thing that, of course, I would know, to write down a client’s goals. I think that was one of them that you told me which may seem simple.

At the end of the session, write down the client’s goals. This person really needs that. A tangible, visual reminder in that way because of the way in which they think. And while that may seem simple, we have a whole lot going on. And so having that overview, that recommendations refreshes me on some of the things that I may already know in that way, but also, a lot of the things that I may not have thought of or not known. Those pieces are really helpful for sure for me in a really practical way in therapy.

Also, knowing exactly what is going on for them in terms of the diagnosis is really helpful because I may have not looked at it in that way before. And that can really help me either identify if I’m able to work on that with them, or we need some other pieces in place of support to address certain areas. 

Dr. Sharp: I got you. So it sounds like the recommendations are really a key part of the report for you as a therapist? 

Jen: Yes, for sure. 

Dr. Sharp: I think that something that as evaluators, speaking to psychologists or mental health professionals who do [00:22:00] testing, one thing that gets brought up a lot is the length of the report. And we have these discussions amongst ourselves about how long is too long. What information do we include? And I’m talking primarily outside the recommendations. So just the text and the results and that kind of stuff. So I’m really curious from your perspective as a therapist, how do you feel about the rest of the report outside of the, let’s say, interpretation and recommendations?

Jen: For me personally, I find it interesting and I look through it and that I can gain pieces of information from that, but that’s less helpful for me in terms of what I’m actually going to be doing with it. And so I think, again, that could really vary between a variety of different therapists, but I can sometimes get maybe even more lost in it just because of what my focus is and what my training is, and what I’m looking to gain from that.

So it’s more of, I guess, an educational part for me, but also it can get long. We don’t have a lot of time to be able to look through every single part or understand every single part, but there are a lot of the parts and really the summary that I think hit on the essential pieces for us.

Dr. Sharp: Yeah, there are some talks and there are some models out there of folks who do assessment where they actually put the summary and recommendations right at the front of the report, underneath all the basic demographic info and referral question, and then just put the results and the test tables and numbers toward the back. And so I wonder from your perspective, would that be more helpful? Do you think? 

Jen: I do think so because of the [00:24:00] setup of it and now I have a pretty good idea of how it’s set up. So I do find myself going to that part. For me, it helps give me more of a framework for, okay, where are we going? The rest are a lot of specifics that are really important in understanding and are necessary for sure to be looked at and to be included on the report, but that pieces it together differently for me with looking at that part first.

The other piece that I really like that I wanted to hit on in the report is the strengths section. And I think that that’s a huge part that is helpful for clients, especially when they’ve gone through so much testing. There’s a lot of anxiety with that sometimes, and they’re really not sure what is going on with me and they’re sometimes used to looking at what’s wrong, that that part is equally helpful because we can really lead with that. All right, here are all of the things that are really strong for you. And even sometimes because of those things, these other pieces are going to be challenging.

And so it helps to be able to explain the other parts that maybe they are having challenges on in a more empowering way. And I think that that’s the biggest piece that’s helpful for clients or what I like about it the most is like, then they can be empowered to be able to know what’s going on with them and get what they need support wise.

Dr. Sharp: Got you. That was a shift that I made, I don’t know, 3 or 4 or 5 years ago. I don’t know when that was when I had a conversation with somebody else in the community and they were talking about evaluation in general, not necessarily our reports, but this person said something like, gosh, those reports, the summary just always focuses on what’s wrong and how to fix it. And I got to thinking like, yeah, that’s right. [00:26:00] Maybe we should bounce that a little bit and started adding a bigger section on strengths in there and really emphasizing that. Even though in my mind, I was always thinking about strengths and appreciating them, I think putting it in writing to make it more permanent until that clients really latch onto it is pretty helpful and necessary.

Jen: Yeah, and I think it helps them be more open to the feedback of the other pieces that they can see, all right. I’m being looked at as a whole person. And again, that part that I really focus on is, this is about understanding the way in which you work more. And that there are a whole lot of tools to help in the areas that are not going well. We really need to know all of these pieces to be able to use the right one. And so, I think that that openness to receiving the feedback for my clients or even getting them in the door really helps to be able to say, this is also going to look at what is going well for you, what is going to come easier for you. And that is equally valuable. 

Dr. Sharp: Sure. Absolutely. Well, this has been great. I feel like I need to ask, we talked about all the good things about assessment, but I’m really curious about the things that are more challenging from your side, or maybe what makes a bad report or a bad “assessment process” and things just to keep in mind with future referrals.

Jen: Yeah. I think that the main barrier is before we even get the client in the door. When I think of assessments it’s like, how do we actually get them there? And all of the logistical things like what insurance do they have, or what does that look like? Schedule-wise, how booked out? Those types of things. Those are the natural barriers that are going to be [00:28:00] there, but that I think have really worked out well, especially, as you’ve expanded and everything. So, that’s a huge part. 

People, once they’re committed to going, of course, want to be able to have it all happen quickly. And that that’s not part of the process that that really can happen in that way because it takes time to assess someone and it takes a big investment for them to go in and do all the testing and do all of that. And so, I think that them valuing that is important and it’s important that it takes that amount of time, but that can be something that’s a struggle for the client.

Other pieces, I think along the way, like I may not really know exactly what I’m looking for. I know that I don’t have all of the pieces. And so, that can be a part that I struggle with. Intuitively, I feel like I need more information and that there are parts missing. I’m sending them to be able to have some of those pieces looked at and put together, but I may not really know, even maybe a learning disorder, maybe it’s something entirely different. And so that can be a part of that comes up for me.

Other pieces are, when they’ve gone through the process and they’re in between before getting the feedback session, they’re wanting to ask me a lot of questions, and of course, naturally I’m not going to have that information. And so, I try and help support them in waiting and collecting their questions and asking them during that time.

The feedback sessions are really helpful. And I also think it’s a lot for clients to take in at that time. It’s a lot of information and that’s exactly what they want and exactly what they need. And it can be overwhelming. So many of the questions [00:30:00] that will come to their minds are after that session is over. And so those are a lot of the ones that I get in that time before we have all of the information or I have the report. And that there’s a lot of questions, that’s the time that we’re where I’m also recommending that they wait while we gather more information, or refer them back to you. That can be a time where they’re wanting to know or they’re maybe confused and they’re not sure what to do right now.

And then just really what’s the next step is the other piece. What’s the very next step that we take is, is usually what they’re asking me as well. 

Dr. Sharp: After the feedback, you mean?

Jen: Yeah. So it’s like, okay, we have all of this information and we have a lot of recommendations. What’s the very next thing that we should do today. And so, in that piece, I think it is helpful to have really prioritized way of knowing what is most important. 

Dr. Sharp: I got you. That makes me think about how we structure feedback and what we leave people with, and wondering if, making it more clear as they take off could be helpful for them almost like giving a roadmap or a checklist or something like that to help guide them. 

Jen: Yeah. And I think that that’s part of why I really liked the summary too, is that I can know, okay, we’re going to go here and I may be able to see a little bit more clear. Definitely, I can see more clear what that roadmap is and what some of those next steps are. For them, maybe they’re taking in the information and trying to absorb that. And that may take a little bit longer. That piece may be helpful to just have a simpler [00:32:00] part at the end of saying, here’s what I would really prioritize or focus on in the coming weeks.

Dr. Sharp: That’s great. Thank you.

Jen: Sure.

Dr. Sharp: Well, I really appreciate your time today and your willingness to come on here and talk with me about assessment from the therapeutic side: what you’re looking for, what doesn’t work so well, and how to really help integrate those services for our clients.

Jen: Absolutely. I’m really glad that you had me on and I really do value the assessment and testing process and the work that you all do there. It makes my job not only easier, but sometimes more possible, more hopeful, and that I can feel more confident in helping people and that they can feel more compassionate to themselves and understand themselves more. And so I think that that’s just a really valuable place that you’ve created to be able to support clients in that area. 

Dr. Sharp: Yeah, absolutely. Well, before we totally take off, let me ask you, Jen, if there is anything else, just keeping in mind that a lot of our listeners are probably psychologists who are doing testing and evaluation, anything from your side that feels really important for them to know, what’s helpful, what’s not helpful, any parting words of wisdom? 

Jen: Sure. I think that one of the things as a therapist that I would put out there to psychologists and people that are doing testing and giving us the information is to not be afraid to really directly let us know like what is probably going to be working and not.

As therapists, we have a lot of different types of training of course, and we have maybe a lot of information and we’re specialized in certain areas, but we definitely don’t have a lot of the information that you have specialized in a lot of [00:34:00] different areas. And so that there’s really nothing too simple to tell us or too complex to explain like that as important.

And so to really not assume that we may know or not know, but let us have the information that you feel is important that’s going to help us aid our clients because we may not have it. And so that I think could be the biggest one. I really appreciate it when someone can say, yeah, I don’t really think that this is going to work very well, and here’s why. This is maybe going to be a better path and here’s why. That is a very helpful piece for me. 

Dr. Sharp: I got you. Well, thank you. That’s super helpful. And again, thank you so much for your time. It was great to chat with you. We do a lot of talking on our runs and consulting with clients. It was really cool to be able to do a little bit more of an interview and hear some of these thoughts that you have.

Jen: Absolutely. Thank you so much. 

Dr. Sharp: Yeah. Take care, Jen. Bye-bye.

Jen: You too. Bye.

Dr. Sharp: All right. Thanks for listening to our podcast today. It was a great interview with Jen Knopp, giving you some perspective from the therapist’s side on what makes a helpful assessment and report.

As always, if you enjoyed the podcast, do me a huge favor, and head to iTunes. Google Play, Stitcher, take 30 seconds to subscribe to the podcast. That really helps here as I’m getting started. If you are interested in more resources about testing, you can always head to the website, thetestingpsychologist.com.

If you really want to take some steps to boost your testing practice and add some services or grow your testing services, you can check out the four-week email course. It’s called the four-week blueprint. You can find that at thetestingpsychologist.com/fourweekblueprint, and all you have to do is enter your email address and you’ll get a weekly email for the next four weeks with pretty concrete action steps to really help you build or [00:36:00] grow your testing services in your practice.

If you want to just connect with other psychologists who are doing testing, head over to Facebook, we have a Facebook community called The Testing Psychologist Community. You can click and search at the top of Facebook, or you can go to the website, which is thetestingpsychologist.com/community.

Thanks again, everybody. I’ll talk to you next time. 

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Hello everybody. This is Dr. Jeremy Sharp. This is The Testing Psychologist Podcast, episode 6.

Hello, again. Welcome to The Testing Psychologist Podcast. I’m Dr. Jeremy Sharp. I hope y’all are doing well. Things are looking good here in Fort Collins. We’ve had two days of really sunny weather. It’s actually been a little warmer than usual. The downside of that is in Colorado when it gets warm, it usually means that there is a pretty strong wind as well, especially in the winter. So, we were outside. Finally got our kids out yesterday to burn off some energy, but had to brave the wind while we were doing so. Either way, I will take it.

We’re going to be talking today about technology. Anybody who knows me can probably name, I don’t know, 2 or 3 things that I am pretty interested in. One is running. If I haven’t talked about running yet, I definitely will at many points in the future. The other is technology. I love technology. I’ve always loved technology and researching technology and figuring out how it can be useful and where to integrate it in my life and that kind of thing. So that definitely translates well over to testing.

When I was in grad school, I was the assistant director of our department clinic or community clinic. And back then even I was so interested in technology. Oh, gosh, like a lot of grad programs, we had to videotape our sessions and play them back for supervision. It was, I think my 3rd or 4th year in grad school, and I was like, what in the world are we doing? We were still using the VHS tapes.  So, I’m proud to say that my legacy from being in grad school here at CSU was transitioning our clinic from VHS to internet recording and live streaming video. So, I love technology for a long time.

Technology is important here in reports and testing because there are a lot of really cool tools out there that make testing a lot easier and a lot more convenient. And so, we’re going to be talking about a few different things.

I’m going to talk about EHR systems and how those can be helpful. I’m going to talk about report writing software. I’m going to talk about some individual tools to help you when you’re writing your reports and making your tables, dictation software, grammar, proofreading software, and things like that. And we’ll also talk a little bit about digital record storage, and how to go paperless. I will spend a little bit of time also on Q-interactive, which is a cool thing. If you haven’t seen it, Q-interactive is an iPad-based interface that has come out over the last few years that allows you to administer and score tests on the iPads. So we’ll talk a little bit about that as well.

Let’s dive into things. I’m going to start just by talking a little bit about EHR and how that can be helpful for you. EHR stands for Electronic Health Record. Now, there’s a lot we can get into in terms of how to evaluate an EHR. I think that’s beyond the scope of this podcast, but I will say there are some really cool resources for evaluating EHR systems over at Person Centered Tech. We will have a link to that in the show notes. But for our purposes here, I’m just going to talk generally about how an EHR can be really helpful for you, even for testing-based practices.

When I was first starting out, again, I love technology, so I was looking for an EHR pretty quickly. I ended up settling on TherapyNotes. TherapyNotes is one of the more popular EHR systems. We’ll definitely include a link to that in the show notes. The reason that I went with TherapyNotes is because they had some, what I consider pretty cool features specifically for testing folks right out of the gate.

One thing that I really liked is that their note template for psychological testing was really comprehensive. It breaks it down by domain of test and makes you enter the amount of time that you spent on that particular test, makes you enter the amount of time that you spent on your report writing, and it totals that all up for you. So, when you look at the interface, it has intelligence tests, academic tests, neuropsychological tests, other measures things like that.

So you can enter every test that you do and really account for the time that you spend, which is pretty important if you’re billing insurance. I’ve gotten requests from insurance companies to look at the records and in some cases that’s appropriate. They really benefit from having documentation of how much time you spent on each measure. So that’s why I like TherapyNotes. Back then, I was also doing a group and they had a really clear functionality for group therapy. So that drew me to them as well.

Now, Simple Practice is another EHR option. I think it’s really popular. You can do your research. And, of course, there are many others out there too. I don’t mean to say it’s just those two. You can do your research. A great site to research EHR systems for mental health is Capterra. Again, I’ll have a link there in the show notes where you can check it out and read all the reviews for all these different software options, and try to get a good idea of what would work best for you.

The general reasons I like an EHR: One, I think it helps a lot with billing insurance again, because it helps you document your time, and that can be really important. Also, it just streamlines the billing process in terms of sending statements, and scheduling your testing.

I use mine to do credit card processing as well. I think this is pretty important with testing. I think a lot of us have hopefully a pretty well-defined cancellation policy. And so, having the credit card stored right there in TherapyNotes lets me charge that credit card if there’s a no-show or a cancellation and it just happens smoothly like that. That makes things easier. You don’t have to chase people down and collect late fees or cancellation fees.

So those are some of the benefits. Just as you consider an EHR system, again, you can do your own research and figure out what works best for you. But I do know that there is a Promo code for TherapyNotes if you choose to go that route.

Now, when we get into the actual report writing, I think this is the place that a lot of us would love to have technology working for us. So there are a lot of options here. There are some options out there, certainly that I would call a full report writing software where often there is, I would just say a pretty thorough, comprehensive setup period where you communicate with the software designers and they tailor your report template to your practice. And once you get all the details input into the report writing software and into the program, then it serves as a master template where you then can go in and input the information that you collect during the testing process.

The ones that I’ve demoed, and I’ll be honest, I don’t use a full report writing software system at this point, but I’ve demoed a few, the ones that I see, they are pretty comprehensive, but they require quite a bit of work on the front. If any of you have experience with others, I would love to hear about that, but the ones that I’ve seen so far, one is called The Psych Writer. A lot of folks that I’ve run into use the Meyers system. There’s one called InsightFill, and one called Psych Screen.

So there are a lot of options out there. Again, I’ll have links to those in the show notes for you to check it out yourself. But the general idea is that you purchase software. Often there is a bulk purchasing option where you pay by the report, but have to buy in bulk. So you might buy like a batch of 20 or 50 reports. They work with you on the front end to set up all the variables, all the information that you like to have in your report, and then they custom build a master template for you.

So then, once you’re done with the testing or with your interview or with your feedback, whatever it might be, you go in and there is usually some variety of dropdown menus where all you have to do is click check boxes or choose options from drop-downs right there in the software, and then once you have done all that and input all the data that you have, there’s a master button at the end where you hit submit, and then it generates this beautifully written report that has all of your information in it. And it looks like a report that you wrote from scratch. 

So, if that appeals to you, like I said, definitely check those out and do some research and see if that would be an appropriate option for you.

Now, I did not go that route. I think ultimately when I really put in the energy to research some of these, which was let’s say two years ago, maybe a year ago, I just found that they weren’t quite flexible enough for me with the templated nature. Like I said, it just wasn’t quite flexible enough. I didn’t feel like I had quite enough control over it. And it’s in my experience, not one of those things that I could just go in and change on the fly because they had coded the software already. That may have changed.  But that’s why I stayed away originally.

Now, what I do at this point is I write my reports right now in Microsoft Word, and I use a combination of tools available, both within word and outside of word to really help me with that. I think like a lot of us, I have put together a report template that has all the main elements. I also have templates for recommendations and those can be just inserted into the report as needed.

One of the most helpful tools that I have used is basically an auto-correct option or a text expander option. What these do at the base level is let you type in a very short snippet of text and then that expands into a much longer detailed piece of text. For example, a phrase that I use a lot in my report is a summary of the type of evaluation. So a sentence that says something like, this full neuropsychological evaluation was aimed at providing appropriate diagnoses and treatment recommendations for so-and-so. So, instead of typing that sentence out every single time in every report, I created a little auto expander where if I type :fulleval, it automatically auto-corrects to that full sentence.

You can do this right in Microsoft. If you’re in the word window, you can go up to the tools option, and there should be an auto-correct choice on that menu. And if you click auto correct, then I think it’s pretty self-explanatory. There are two windows where it says, replace blank with blank and you just fill those in. That can really shorten the writing time, especially if you have like I said, sentences that you write over and over and over.

Now, I’d say the next step up from that is using software that allows you to do a hybrid between a full report writing software and just a simple auto-correct. So one piece of software that works really well for that is something called TextExpander. This has been around for a long time primarily for the Mac, but they’ve also expanded to windows. There are some other options too, but TextExpander is really, I think probably the most well-known version of this.

What that does is it basically allows you to create what they call snippets. Snippets are basically those short versions of text that act as shortcuts to create longer versions. Now, the cool thing about TextExpander is that it allows you to actually create your own templates. That’s why I said it’s a hybrid with the report writing software that I talked about earlier.

So with TextExpander, you can create longer snippets. You can also create bigger paragraphs. You can create dropdown menus and checkboxes. And if you want, there are two different ways that you can program it to output. The default output is that it just generates a text file which looks fine. It’s totally fine. You can do bold and formatting in italics and headings and that kind of thing, but if you’re willing to put in a fair amount of work on the front end, you can also have it generate a file that will open in Microsoft word. And that can be really helpful. Like I said, it takes a little bit more work on the front end, but definitely doable.

So, you have two options just for text. And those have been super helpful for me. That cuts out a lot of time, especially with those phrases and paragraphs that you just type over and over and over. 

I’ll be honest. I still haven’t been able to get comfortable with any sort of templated interpretation. It seems like my interpretations end up fairly personalized and fairly unique for each client. Even if I’m discussing the same presenting concerns or diagnostic impressions, I always end up writing them just slightly different based on the client. So that part is fairly immune to shortcuts, at least for me, but that might be different for you.

Now, some other pretty simple software options. A lot of people use Excel to make a table formatter where you can input the scores and write a little bit of, I guess you’d call it code in Excel where it transfers and converts the scores to standard scores and maybe percentiles and ranges. There are a lot of options out there. I think it’s fairly easy to do on your own as well, but if you are looking for one, I’ll have a link in the show notes to another psychologist out there, Joel Schneider. He has actually several self-made tools that can help with report writing. His a table formatter is just an option you can look at as an example of how to do that. So again, just another piece of software that can help eliminate a little time for you.

Now, a lot of folks also use dictation software. I imagine you probably heard of this. There are a few options for dictating. It’s actually gotten a lot easier over the years. It used to be that you had to use a pretty formal piece of software, like Dragon. Dragon has an option for medical terminology that could really help, especially if you’re in a hospital setting, or if you just happen to use a lot of medical terminology in your reports, there is a medical module that would probably help a lot with that.

Now, if you have a Mac and I’ll be honest, it’s just going to come up over and over and over. I’m highly biased toward Mac. I love Mac. That presents a little bit of trouble with scoring software. Sometimes it is only for windows. We do have a PC in the office, but I prefer Mac for pretty much everything I do personally.

With Mac, there is built-in dictation in your in your system settings. So if you go to system settings, you should just be able to search dictation or speech, it will come up and you can turn that on. It’s pretty good. Definitely helps if you have a microphone, but yeah, that’s an option. It’s a free option and it works fairly well. Some folks I know will use a smartphone to record and then dictate their interviews. There are quite a few options for dictation software as well.

Now, if you want to take it to the next level, there are two tools out there that can transcribe. Is that the right word? Convert your dictated speech into searchable text, or even convert your handwriting into searchable text. Smart Pens are an option there. So if you’re in your interview, if you still like to take handwritten notes like I do, you can take your handwritten notes with a Smart Pen.

This is paper and pen system that often will have a voice recorder in the pen, and then you use paper that has, I think has microchips in it. That sounds like magic as far as I’m concerned, but you take the notes with the pen, it goes onto the special paper, and then you can transfer that via the computer to software on your computer. And it will convert that to searchable notes. And it will also allow you to record what was being said in the interview and sync that with the notes you are taking right at that point in time. So you can go back and tap on the microchip paper and it will play back what was being said at that time when you were taking those notes, which is really cool.

Another app that is in the same ballpark is an app called Notability. And there are others too, but these are just the ones that I know of the most. And again, these are apps that just sync spoken information with written or typed notes. You can always upload those notes to the computer. And then they’re searchable. They turn into a word document or a text document. So lots of options for actually writing the report or getting your notes into a searchable format and putting all of that together. A lot of folks I know will just dictate the interview right after they do it. And that tends to save quite a bit of time rather than typing everything out themselves.

Now, once you get the report written, I think it’s fair to say that all of us hopefully are using a template of some sort, but when you use a template, of course, the risk that comes with that is that you’re going to make mistakes, that you may forget pronouns, forget to switch pronouns or maybe even leave a name in there, something like that.

One little thing that I did way back when was just in my master template, instead of copying and pasting from one client to another which some folks do, I just made a master template where I can substitute gender-specific pronouns and use the general terms, first name and last name. So I can just do a substitution right at the beginning of the report when I write those. Pretty simple, but it helps a lot.

So once you get your report put together and you think you’re ready to proofread it and send it out, I’ve gotten pretty interested in proofreading and grammar software. I think the spell check and the grammar check on word are decent at best. And so, there are some other tools that can really do a better job.

Grammarly, I think is probably the most popular one. It seems to have the widest application. There’s a Google Chrome browser extension. So, it tends to work in most text fields that you’re typing in on the internet. So email, blog posts, things like that. It also works on windows and works on Mac. Although, I don’t think it works on word on Mac, so that’s something to consider. Grammarly is really good. It, I think does a much better job at proofreading than just your standard word proofreader.

Another one that’s pretty similar is called StyleWriter. There’s another one called Ginger. So there are a few tools out there that I think are definitely worth looking into if you’re interested in grammar and proofreading, which you should be. I think a well-written, well-proof-read report is one of the most powerful marketing tools that you can have as a testing psychologist. And those tools can help quite a bit.

So let’s talk just a little bit about digital record storage. If you’ve been testing for any amount of time, you know that the files can be enormous. So each of those testing files, if you’re doing a pretty big battery, can end up being an inch or inch and a half thick and that adds up. I think I got to the point where I had, goodness 20, I don’t know, 25 banker boxes full of files. And I finally was like, we got to do something about this. This is terrible. I’m running out of space. My office looks terrible.

And so, I really looked into the option of digital record storage. A lot of folks have been doing this for a while. I was a little late to jump on the bandwagon with this, but it has made such a huge difference just in terms of being able to search through records, being able to find things easily, and of course, decluttering the office, which is awesome.

One thing that you got to keep in mind with any digital records storage is HIPAA. Make sure that whatever service you use, they are willing to sign a HIPAA business associate agreement. I should back up a little bit just to say that I am talking primarily about cloud-based services. Now, there are EHR services that have electronic record storage, of course. I prefer to go with Google drive only because we have all of our email accounts through Google drive and I just run everything through Google for the most part. And so, it made a lot of sense to integrate our records with Google drive as well because you can insert files and search and share and all of that pretty easily.

To have Google drive be HIPAA compliant, you do have to upgrade to their business version. It’s a pretty nominal fee each month and they will sign a business associate agreement. I believe Microsoft one drive will do as well. But that’s just something to consider if you’re thinking about digital records.

If you’re interested at all in guidelines around HIPAA and digital records and that sort of thing, there are a lot of really cool resources over at Person Centered Tech website that really specializes in technology for mental health professionals. I will have a link to that in the show notes so that you can check that out.

For us, the combination of Google Drive and a really good scanner has just made a huge difference. I’ll put in just a quick plug for the ScanSnap iX500- the scanner we use. It’s a super quick double-side very easy-to-use scanner. It goes really fast and the software integrates really well with both Mac and PC. It’s wireless so a lot of people in the office can use it. And I think it’s been vetted pretty well by a lot of psychologists and neuropsychologists out there. I’ve gotten a lot of pretty good feedback from others around it too.

So that’s our setup. We use Google drive with the business associate agreement and the ScanSnap iX500. There will be a link to that also in the show notes to get it on Amazon, if you’re interested. And that has helped a lot. Now we can search our records. Anybody can access them. I don’t have to pour through these paper files. And it is just so much more convenient.

Now, just a word about what records you would actually scan in with testing. I’ve heard people go both ways, but I take more of a comprehensive approach where I will scan in every testing record that we have. We cut the test booklets up the middle, we scan every page of the test booklets for the forms that have carbon like say the Brief or maybe a CAARS or something like that, where you have the two layers. We scan both the answer layer and the scoring layer. So that’s just a word on that if you were to ever need that raw data or those records. We just scan it all in just to be sure.

I would be totally remiss to not talk about Q-interactive. I think Q-interactive is arguably one of the more important technology advances for testing over the past few years. Like I said earlier, I’m a huge fan of technology. So I jumped on the Q-interactive bandwagon really early. I mean, as soon as I could be fairly certain that the test-retest or the reliability between paper tests and Q-interactive was solid, I started to use it. I think a big part of that was I just wanted to buy two iPads to be able to play with them, but the convenience was attractive.

The whole idea with Q-interactive is that you use 2 iPads that end up linked together. So you have to buy 2 iPads to run the system. They communicate with one another and they basically serve as the interface between you and the client. Again, we’ll have a link to Q-interactive in the show notes so that you can check out what it’s all about and read a little bit more and everything. But the general idea is that these iPads will be the interface between you and the client. And it’s amazing.

They have the option to do many tests on the iPad. The WISC, the WAIS, D-KEFS, NEPSY, WPPSI  the CVLT, the KTEA, the WIAT, and even some others. So there are a lot of options for fairly major tests. I think it’s worth a trial or I would certainly look around and talk with other folks who use it.

We eventually moved away from the iPads really for two things. There are some downsides to being an early adopter. The downside for me is that early on, the software was fairly buggy and we were just running into quite a few issues with just administration. It wasn’t as smooth. That has definitely gotten better over the years. One of the big things for us too, is that the scoring output from the iPads just was not the same as I was used to from say the WAIS or the WISC scoring program through PsychCorpCenter. But that has also changed. They’re definitely getting a lot better with that.

The other thing that turned us off was the cost. I think that using Q-interactive is good for folks who maybe do less volume in testing. Their cost structure is that you pay an annual license, which gets you a certain number of tests that ranges from $225 to $300, depending on how many tests you want access to. And then they charge per sub-test. So it’s about $1.50 each. They do do bulk discounts once you get above a certain number of subtests a year. For a WISC that has 10 subtests on it, it’s going to cost you about $15 plus the cost of a booklet.

So if you do the math, I think the idea is that it would be more cost-effective for someone who doesn’t want to buy the full test kit which can run $1,300 or so. Granted this could be off, but with the cost of the sub-test plus the test booklet, I think that balances out at about 50 or 60 administrations. So, if you would see yourself doing less than that over the course of 2 or 3 years, then it might be a good choice for you. But we just went ahead. We bought the full paper kits because we just do a lot of volume of testing and it was more cost-effective. I think Q interactive is a really good choice for folks who maybe aren’t doing quite as much testing.

So you can do some research and check that out. It definitely makes things easier. The advantages are that at scores on the fly. As quickly as you can enter the scores for the subtests, it will score it on the fly. So you can make pretty quick decisions about adding or modifying your battery if you need to. And it takes out the human error of scoring. So that’s kind of cool.

I will say that I found it to be super helpful in particular on the CVLT. Some of you out there would probably be familiar with just the tedium of administering that test and even using that scoring software where you have to type in the words. It’s really nice on the iPads. You just tap the words as the individual says them. And, of course, you have occasional times where you have to write in your own words, but it works really well. And that’s probably the one where I’ve found the biggest advantage so far.

So that’s just a little summary of Q-interactive. Like I said, you can check it out. My hope is that I will have some folks on from Q-interactive who can do a nice interview with us and really talk about the ins and outs of Q-interactive here sometime in the future.

So that’s my primer on technology in testing. Now, there are a lot of other options out there. I’m sure a lot of software that I didn’t even mention. I would love to hear from you if there are particular tools that you really enjoy or things that are worth checking out. Like I said, I love technology and I will continue to explore technology in the testing world.

All right. Thanks for listening today, everybody. I have two really cool interviews coming up in future episodes. I’m going to be talking with Jen Knopp, a local therapist, who’s going to talk with us about how assessment is valuable to a therapist and what therapists might be looking for in reports and assessments. I have an interview with Joe Sanok from Practice of the Practice. He’s going to talk with us about basic business and how to slow down and make the most of your time. And I’ll be talking with Dr. Amy Connery from Denver Children’s Hospital about validity testing and performance testing in kids, and how to make the transition from being a regular psychologist to a neuropsychologist.

As always, we have a few resources for you. Definitely check out the website and the blog. If you are more of a reader and like to get your info that way, the website is thetestingpsychologist.com. If you’re interested in taking some really concrete steps to build your testing practice. You can always sign up and download the four-week blueprint. That’s at thetestingpsychologist.com/fourweekblueprint. And by doing that, you’ll get a weekly email every week for the next four weeks with several action items that’ll really help you take some concrete, clear steps toward building your testing.

If you’re interested in connecting with other psychologists and people doing testing, you can always check out our Facebook community, that’s at The Testing Psychologist Community. You can search for that on Facebook and that top bar. It’s growing by the day. We’re having some good discussions about testing and resources and all sorts of good stuff. So check that out if you want to jump in.

As always, thanks for listening. Here in the beginning stages, it’s super important, you’d be a huge favor, if you enjoy it, subscribe, rate, and leave a review of the podcast and we will continue to grow. Thank you. I’ll talk to you next time.

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Hey everybody. This is Dr. Jeremy Sharp. Welcome to The Testing Psychologist podcast episode 5.

Hello. Welcome again to The Testing Psychologist podcast episode number 5. I’m Dr. Jeremy Sharp. Good to be with you today, as always. I hope everyone is doing well. Moving on toward Christmas time. I imagine this episode will be coming out a little after Christmas, but right now we’re headed to Christmas time and that is exciting.

Kids make Christmas a whole different thing, I have found. It’s a lot more exciting. It’s so cool to see them love their Christmases and just get excited about it; listen to Christmas music and be bouncing around the house with a little more energy than usual. Usually, that’s nice. Sometimes not.

Today, we are talking all about time management and scheduling with running a testing practice. So as we’ve gone along here these first few episodes, we started with an overview of things to consider with testing and then dug deep into different aspects of a testing practice over the last few episodes. We first talked about all the financial aspects: billing, how to finance a testing practice, how to market and get testing clients, and now, we’re going to be talking all about time management.

Time management in a testing practice is huge. Here’s how I came to this. I think as I mentioned before, when I started and really began expanding the testing side of my practice, it happened really all at once. I got a whole lot of referrals all at the same time. That was a big jump from previous referrals that I’ve gotten. And so, I had to really figure out how do I manage all this time, because I recognized there was an opportunity to build this testing practice and I had a full therapy practice at the time and had just been really doing testing on the side. So I had a little bit of a panic moment or really panic probably a month or two, where I was like, how do I handle all of this?

I’ve had many weekends, unfortunately, over the years of being in the office, catching up on reports. Oh, I have to work and, oh, I’m behind, that sort of thing. So time management is a really big deal. It took me, gosh, I would say at least a year to completely transition from full-time therapy practice with testing on the side through a hybrid period where I was pairing back my therapy clients and ramping up the testing. And then finally got to the point where at this point I don’t do any testing. My goodness. I keep messing up those words. At this point, I don’t do any therapy and primarily do testing.

So, let’s talk about time management. A big thing here, maybe a no-brainer, but maybe something you haven’t recognized unless you’re doing it day-to-day and week-to-week is it testing takes a lot of time. Depending on the practice model, which we can talk about a little bit, I’m going to assume that most of you are doing the entire evaluation from start to finish, meaning your interview, whatever testing you’re doing, whatever writing you’re doing, and then feedback if you do those.

For me personally, I have a tendency to be really optimistic about getting things done and about how long things will take. So I’m just going to run through and break down different types of evaluations and make it very clear how much time each of these might involve.

Let’s start with very brief evaluations, which I would say are maybe personality evals, substance use evals, some forensic evals where you’re really maybe just doing a personality test or two or a behavior checklist and that’s about it. So even for a brief eval like this, you’re going to probably put in at least three hours: an hour for an interview, an hour for the client taking the test, and if you want to get paid for that at the psychologist testing rate through insurance, you have to be sitting there with them, so that’s an hour of your time as well, and then an hour to write and deliver the report. So there are your three hours already.

Now, if we’re talking about our brief, let’s say cognitive eval, and I think the best example of this is a colleague of mine at The Children’s Hospital in Denver, Amy Connery, has developed and used for many months or years what she calls the one-hour concussion protocol.

So this is a complex eval, very thorough, but also as brief as possible, I think. So that is still going to run you about four hours: an hour for an interview, one hour on a good day with an uncomplicated case for testing- that can range to two hours though, an hour to score and write the report, and then an hour for feedback. So, even a very brief cognitive eval is going to be about four hours.

So from there, maybe we get up to a full evaluation. With a full evaluation, now I’m talking like full neuropsychological battery, maybe full psychoeducation battery. In this case, we’re talking probably seven hours. So again, on the conservative side, so one hour for the initial interview, let’s say four hours for your testing battery, which includes scoring if you’re really good, again, pretty conservative. If you’re really good, I’ll give you an hour for report writing and then an hour for feedback. That’s seven hours for a decently full evaluation.

Now, that brings me to our agency’s model, which is somewhere in the middle. With that, our evaluations are probably 10 to 12 hours. We, I like to think go a little bit beyond minimum requirements so that we can be a little more thorough, but that means more time. So I do a two-hour interview for everyone really because, to be honest, I don’t know how people do an hour interview. I mean, by the time I go over confidentiality, payment policy, that sort of thing, that takes about 10 to 15 minutes. Build a little rapport with the family. Talk about how the interview is going to go and talk about the steps after the interview. That takes another 5 or 10 minutes. So, that’s a half-hour almost of time that’s eaten up just with policies and introductions and get to know you kind of stuff. And so, a half-hour for the remainder of the interview just does not fit for me.

So I moved to a two-hour interview. I do an hour of school observation in many cases where it’s appropriate. We do about 4 to 5 hours of testing- the actual battery. For me, if it’s a good day, it’ll take about two hours to write the report and then, I’ll typically do an hour to an hour and a half for feedback. So, our evaluations here at the clinic end up around 10 to 12 hours.

Now, then you get into what I call mega evaluations, which might be well, certainly the evaluations that I did in grad school. I know different people have different training, but my goodness, we learned this huge breadth of testing and had to write a corresponding report. So, we would spend just hours and hours on these reports, but outside of grad school, in the real world, that would be maybe like a CFI (child, family investigator), or a PRE (parental rights evaluation), maybe forensic evals. And with that point, the sky is the limit. I’ve seen PREs go up to 40 hours. I’m sure some of you have seen more than that. So, it depends on your practice model and what kind of evaluation you’re doing, but you can really get into substantial amount of time to do evaluations.

I am a big fan in general of crafting your practice to fit your life rather than the other way around, but unfortunately, I think I went about it the wrong way- integrating testing into an existing practice. For years, I was fighting to get my time management under control because I was spending so much time on testing and reports.

So, there are a lot of ways that you can streamline your testing and streamline your report writing, we’ll get into those, but I think the takeaway here is just as you’re thinking about either integrating testing in your practice or building a testing practice from the ground up, you got to think that how much time you’re going to dedicate to these things.

So again, I think I talked about last time, this dilemma of how a lot of psychologists can get into the trap of scheduling time for face-to-face appointments. So interviews, testing, feedback, but then don’t have time for writing, and then you fall behind on reports. It takes several weeks or months to get the report back to the client. That’s a situation that we would like to avoid. So, thinking about time management, I think is really, really important and then not to get ahead of yourself and maybe make the mistake that I have in the past, which is being very optimistic about how much time I would be able to spend on my testing and how much I’d be able to get done.

Let’s see. One way that you can streamline your testing process is with outsourcing. I employ a variety of outsourcing methods here in my practice that others do too. This is not original to me by any means. But one thing is that you can adopt a tech model where a psychometrician administers a lot of the tests. That of course frees up your time to do other things.

Now, you still have to train those individuals upfront. I think it takes really good training and a pretty heavy investment in their training to make sure that you can trust someone else to do your testing for you because so much happens in the observations while you’re doing testing. So there is that and that frees up quite a bit of time. And so, my psychometricians that work here administer a lot of the tests and they also do a lot of the test scoring and a lot of what I call the templated writing. So, they put the scores into the tables, which then go in the report.

Now, I also outsource the writing of histories. This is an idea that I got from one of the folks who really taught me a lot when I was building my practice, Arón Bautista at the Austin Center for Therapy and Assessment. Arón talked with me about how they have skilled writers, maybe undergrads with an English major or a psychology major who are good writers who write the clinical histories.

So I found that this has helped. It helps me a lot. It helps the other psychologists in our practice a whole lot because she just finds history writing torturous, and it’s so much nicer to have someone else do it. So, I learned to take really good notes while I’m doing my interview and it’s forced me to structure my interview pretty clearly because then I pass along those notes to someone else to do the history writing. We have an electronic record system where those folks can access the notes online because they’ve been scanned in and they write the history and then plug it into our report template.

Another thing that you can outsource if you have an administrative assistant or again, maybe an undergrad is proofreading. Having someone proofread your reports before they go out, I think is pretty crucial just to avoid any of those errors that might come from using a report template, which we’ll talk about in a bit, and also helps you know and just have some peace of mind that you’re sending out a report that is good. So, that’s another thing that you can outsource and free up a little bit of your time.

Now, another big place for streamlining your time is of course in report writing. You have to have time to write reports. It seems like with everyone I talk to, psychologists who have tried testing but abandoned it, those who stick with it, everybody talks about how report writing is the hardest part of running a testing practice because like I said, I think it’s exciting. I think it’s easy. It’s engaging for most of us to schedule those face-to-face appointments and really get into that and even do the testing.

The testing itself and scoring are pretty enjoyable for me, but then we do get into a little bit of trouble when it comes to report writing because a lot of the time it feels like homework, and homework was like grad school. I don’t think many of us want to go back to grad school. So, report writing is a tough thing for a lot of us.

So what I have done is a few things to create time, to write reports. Initially, I tried just doing it in between therapy clients. That didn’t work at all. What I found about myself and this might vary from person to person, but I really need pretty big blocks of time that I can sit down and really work on a report.

For me, it takes me about two hours to do a report from start to finish: editing, interpretations, recommendations, all that stuff. So I need a good block of at least two hours to sit down and get a report done. Otherwise, I find myself more distracted, checking email, and checking Facebook. It’s just hard. I can’t settle in and get it done. And there is research to support that too, that the more you try to, I’m not trying to multitask, it’s not like I’m trying to be distracted, but the more times you go back and forth between the task you’re working on and some external distractor, the worse your performance gets.

What I have done is many iterations of creating blocks of time. I initially started with taking off just one day a week to write reports and that worked pretty well, but I found that I was not getting as much time as I needed. I would occupy that time with administrative tasks or errands or something. One day did not end up being enough. Then I moved to a model where I took off every 4th week to just write reports. That worked better. It definitely gave me more of a feeling of freedom and a feeling of that.. well, I didn’t have anxiety about writing the reports and didn’t feel like I always had to be writing reports where I was falling behind.

But the place that I’ve gotten to now that has worked the best, and again, this is another example that was inspired by the staff at Austin Center for Therapy and Assessment and James Harrison, who’s the head neuropsychologist down there. He employed a schedule back when I talked with them a few years ago where he does basically two weeks on and two weeks off.

What I mean by that is two weeks on of only seeing clients face-to-face. So interviews, feedback, and testing sessions. And then he would do two weeks off where he would only write reports. So, I have adopted that and changed it to fit my lifestyle where now I do one week on and one week off.

And again, that week on is when I’m doing, it’s basically eight hours of interviews, feedback, and any testing that I’m doing. And then on my week off, that’s my time where I know I have a whole week, I can do some administrative stuff, but really I have full open days to just write reports. And that works really well for me. I find that I can get a lot done when I get in the zone with writing reports. And again, this is supported by research that the more you do something and the more familiar it is, the easier it comes.

So I can get in the zone and really just write reports all day long. I find that my typing and my writing flows better. I’m thinking about things more clearly, I’m conceptualizing better, and that has proven to be a really helpful schedule for me at this point.

Now, you have to think about just for yourself, how much time do you need to write reports? The time that I found varies from 30 minutes, which is basically superhero status in my book to finish the report, all the way up to gosh, maybe four hours or more on more complicated cases. So you can think about it for yourself how much time does it really take to write your reports?

Maybe you’re doing really brief evaluations that you can crank out in 15 to 30 minutes, or maybe you have a computer-generated report that does it for you. That’s going to make a big difference whether you need to dedicate a small amount of time or a large amount of time.

Now, report templates are a huge part of writing reports I think for most of us, especially if you’re doing longer reports. I use templates both for the report in general and for my recommendations. The thing with using templates that you have to be careful of is or things that I hear complaints about maybe from around the community are leaving in other clients’ names, not changing the pronouns, and not personalizing the recommendations for the person that you are working with. So those are just things to be aware of and be extra careful.

Some ways that I have combated that are basically to create a homemade report template that uses form fields in word. So fields like first name, last name, and then the pronoun field. That’s the first thing we do when my staff is putting a report together is to check the client’s name, of course, input the name and the gender, and then we changed the pronouns appropriately and just go through and do, edit, find, replace, and make sure that all the pronouns are appropriate and input are our pronouns set. That’s the first thing that we do. I do not reuse templates from one client to another with actual client information. We start from just a boilerplate template that has a first name, last name, and like I said, the pronouns. 

With regard to the recommendations, the approach that I have taken is to basically create separate files for different sets of recommendations based on diagnosis or setting and basically, put any recommendation under the sun into that recommendation file. So then when I’m writing the report, I can go in and I can say, okay, I need recommendations for ADHD.

I write all my reports in word, and so, I will go to the word menu and click on insert, and then there is a file option, and then I insert that recommendation file. And then I personalize it from there. So, adding, or mainly subtracting any recommendations that don’t fit that particular person.

Now, there are some other tricks that can really help if you write your report in a word processing document, which I assume everybody’s doing. One of the big ones that has really helped me is using the auto-correct function in word for common phrases that I use. For example, I write a lot of diagnostic reports where I’m having to put in the DSM-V and ICD-10 codes. So I created little shortcuts for each of the diagnoses.

How you do that is, in the word menu, you can go to tools, then you click on auto-correct, and at least on a Mac, which is what I’m using, there are two windows where you can type it the phrase you want to replace and the phrase you want to replace it with. The replacement phase always starts with a semi-colon and then an abbreviation. For example, I diagnose a lot of reading disorders and dyslexia. So I do ;sldreading, and then I replace that with the DSM-V and ICD 10 code for specific learning disorders with impairment in reading. And so when I type that shortcut ;sldreading, it automatically expands and inputs that full term.

I’ve used that to do longer phrases and templated paragraphs that I’ll use a lot. So you can use that tool for really as much as is appropriate. And if you put some time into it on the front end, you can really save a lot of time later down the road when you’re writing common phrases over and over.

Now, there are a lot of options out there for full templates. We’ll have a lot of links in the show notes. It depends on the type of report you’re writing, of course, and what kind of template you might be looking for, but I would definitely encourage you to do a good search, again, check out our show notes and try to get a sense of what kind of templates are out there that could help you.

Beyond that, there is third-party report writing software. Now, these are aimed mostly at folks doing objective psychological testing with at least behavioral and personality measures. But some of these software programs also try to build out full reports from basically just inputting form fields and checking boxes. I have not personally used any of these, so that’s the disclaimer here, but I can list a few.

PsychWriter is one, DocuNimbus is one, and there’s one called PsychSCREEN. So if those are interesting to you, you can certainly check it out. I found a few colleagues who use those resources with some success. They don’t seem to be super widely adopted at this point, but they are out there and I am sure they’re only going to get better. So those are worth considering as well.

Now, there’s always the test maker or manufacturer scoring software as well. I’m thinking of personality measures. They will give you an interpretive report. Now, of course, you’re not allowed to just copy and paste because that’s infringing on trade secrets and that sort of thing, but it gives you a good idea of what kind of things to be thinking about and how to write your own interpretation.

The intelligence tests and academic tests, at least from Pearson, like the Wechsler scales and many others will do software-based reports that come from their software. A lot of folks use that as well. I find them to be pretty thorough, but I’m also not as personal. So I don’t tend to use those. I try to do my own interpretation based on the client that I’m working with, but that can save quite a bit of time as well.

Now, one thing that I have to mention and have mentioned a little bit, but we’ll go into a little bit more specifically here is the technology available, and this is something that is just more up and coming as we go along. There is significant technology available to help with testing and report writing. Q-interactive is a big one, PARiConnect is another. Most of the publishing companies have some version of online or digital testing and the research is pretty good when you compare to paper and pencil versus digital administration. So these are getting more and more popular.

Like I said, well go into the technology involved in testing and report writing in a future episode in way more detail, but for now, just know that those are out there. We do use Q-interactive here in our clinic for certain measures. I found it to be a little bit, let’s say buggy and clunky with some administrations, but we do use it. For example, with the CVLT. It works really well and is pretty straightforward. So like I said, we’ll talk more in detail about the technology as we go along.

These are just a few ideas and things to think about when you are trying to structure your practice to find the time to write reports, be efficient with writing reports, and make sure that you’re structuring your practice to work for you instead of you working for it.

This is just another example of a time when I think about a phrase that comes to my mind a lot, which is, it seems a lot more difficult to know what to do with all your clients than how to get more clients. Managing the clients and the business you have often ends up harder than actually getting clients in the first place. And I think testing is particularly relevant for that because you have to set boundaries around time and when you’re going to get this done or else you end up with delayed reports and that’s not good.

So thank you again for tuning in to The Testing Psychologist podcast. This is really, really fun and exciting. Like I said, last time, I love putting together these podcasts episodes and talking with you all about building a testing practice.

I haven’t said this in two episodes, but as we are getting started, it’s really important and huge favor if you could go to iTunes or wherever you might be listening and subscribe, rate, or maybe even review the podcast. That will really help me as we are launching and trying to move up those charts in iTunes. And of course, you can go to our website, thetestingpsychologist.com for articles, information, listen to past episodes, all that good stuff.

There is also the opportunity to sign up for my four-week blueprint, which will over the course of a month, send you a weekly email with really concrete action items each time that you can use to build and grow your assessment practice so that at the end of that month, you should be just about ready to go with new testing services. So check that out; thetestingpsychologist.com/fourweekblueprint. And if you want to connect with other psychologists or mental health professionals who are doing testing and assessment, you can always check us out on Facebook at The Testing Psychologist Community.

I look forward to talking with you next time. We’re going to be tackling everything technology and how that is related to testing. This is one of my favorite topics. I’m really looking forward to chatting with y’all. Until then.

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