General Technology,
Season 1,
Telemental Health,
60 MIN 01 SEC

Episode 107 – Awesome-ify Your Practice for 2018

January 04, 2018

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Rob and Roy discuss three significant steps to take to awesome-ify your private practice in 2018. They are joined by blogging expert and coach, Tamara Suttle, who discusses the importance of online reputation management.




Show Notes
  • :13

    Awesome-ify Your Practice!

  • 1:12

    Big Picture Practice/Business Evaluation

  • 4:58

    Setting Revenue Goals

  • 10:28

    Expenses and Taxes and Planning, Oh My!

  • 14:52

    Being Proactive

  • 16:03

    Guest Spot – Tamara Suttle – Managing Your Online Reputation

  • 37:17

    Describe Question – Tamara, Tell Us About A Time When You’ve Felt Important.

  • 46:28

    Is It Time For You To Do Telemental Health?

  • 59:16


Episode Transcript
Announcer: Therapy Tech with Rob and Roy. The most fun therapists can have listening to a podcast about technology.  
This episode of Therapy Tech with Rob and Roy is sponsored by Hushmail, the secret to simple, secure communication,  
Rob: Welcome to Therapy Tech with Rob and Roy. I'm Rob.  
Roy: I'm Roy.  
Rob: We're going to talk about three ways you can awesomify your practice in 2018.  
Roy: Awesomify? What kind of word is that, Rob?  
Rob: It's just something one of us made up within the last five minutes. I already forgot who.  
Roy: I forgot, as well. I think it's just too awesome, you know, it can't be-  
Rob: It was either awesomify, or awesomitize, or awesomate.  
Roy: Awesomate.  
Rob: But we decided that awesomify was the way to go.  
Roy: Yes. Awesomate sounds like a chemical compound.  
Rob: We don't want to get into that.  
Roy: No.  
Rob: We don't have the clearance to handle those kinds of things.  
Roy: No. We're not certified for that. For awesomate. We can only awesomify.  
Rob: That's right. I'm not going back to more school for that, so.  
Roy: That's right.  
Rob: I don't want to take chemistry classes. I'm not going there.  
Roy: Well, that's fair enough. That's fair enough. So, I think in this episode, we're going to have three perspectives, right?  
Rob: Yes. So, we're going to present three perspectives today, or viewpoints, that kind of all fall under the same umbrella, which is to step back and kind of take a big picture look at your practice. Where you're at now, where you'd like to be. One of the things I always do when I'm doing consulting with folks is I ask them that big question, the five year question, what do you want your practice to look like in five years?  
Roy: Oh, wow.  
Rob: I tend to see people ... We're so focused on doing the counseling, the therapeutic work, that's what we all are here for. We don't like to deal with the paperwork and all the other stuff, so people tend to handle that stuff in kind of a piecemeal manner, "Oh, well, I'm going to decide about how I'm going to deal with credit cards today," and then the next week, "Well, maybe I'm going to an EHR." So, what we're talking about today is more about stepping back and looking at the big picture, how everything works together to create the practice that you want, and make decisions from that vantage point.  
Roy: Yeah, well that sounds pretty great. I'm sure a lot of people would like that.  
Rob: Yeah. From my perspective, again, it comes often in the realm of software. I'm going to relate it to other things, but like I see often on online forums, people saying, "Hey, what's the best EHR for group practices?" Questions like that, and they're good questions to ask. You certainly want to seek out a perspective of others, find out whose happy with their EHRs. It's really important to step back and see how does this technologies and solutions you are choosing and looking for fit into your big picture of what you want to accomplish with your practice, because your goals might be entirely different from someone else's.  
Roy: Wait, so, I just want to check in, Rob, are you suggesting people end up just changing all their tech around?  
Rob: No, it's not about changing. It's more about doing an evaluation. Hey, where are we at now? Where do we want to be down the road? Do we need to make any changes to get there? So, it may be that you're already doing everything and it's working just fine, but it's about taking that big picture of where you want to be, and looking at all the different facets of your practice, and seeing if they are set up to get you there. So, you may keep all the technology that you have, but maybe change some of the workflow, maybe change some of the responsibilities that different people in your office take on. It's more about identifying all the pieces and how they're taking you where you want to be, and making improvements where they're needed to streamline things and get you there.  
Roy: Got any, like a template, or a like a guideline for how people can go about with this evaluation?  
Rob: That sounds like a really good idea.  
Roy: Yeah, I figure we got a good podcast here. Here's a chance for you to tell everybody how you do it.  
Rob: I should probably come up with a template or something like that. I've helped enough people with these through consultations, maybe I need to-  
Roy: That's true.  
Rob: ... develop some kind of walk you through kind of template.  
Roy: Hey, you should.  
Rob: If you want to kind of scratch down your own template, start with at the top should be your statement of what you want your practice to look like, what it looks like now, what you want it to look live in five years, and that's what you're going to keep going back to. Then look at the different facets of your practice from the clinical side to the administrative side, to even the marketing, and we're going to talk about that a little bit, and look at each facet.  
Hey, is my technology delivering what I want it to deliver? If not, where are the gaps? Identify the gaps to things that aren't moving you in the right direction. Identify how your administrative, if you have, some people out here are solo clinicians so you're the administrative staff, so you'll be evaluating yourself. The way that we handle workflow, everything from scheduling people to collecting payment, to dealing with insurance claims, do we have a good workflow? Do we get things done in a reasonable amount of time? Are we accomplishing the revenue goals that we've set for ourselves?  
Roy: Revenue goals, wait, tell me more about that. That's really exciting.  
Rob: I think it's really important that everybody does set revenue goals. I know a lot of people kind of slide into private practice and it's very exciting. Hey, I get to work for myself, but we don't get a lot of business training in our graduate programs. I know we've talked about, hey, we don't get training on HIPPA, but we don't really get training on business either. So it's really important to set revenue goals to know what you're going to be able to pay yourself. Whether you're going to be able to incorporate new technologies, new facets of marketing. Knowing, hey, how much can I spend on this, that? How much can I spend on things that I don't even know are going to happen, kind of having a contingency while still paying yourself a reasonable amount of money.  
Roy: Okay, so help me out here, Rob, because we see people asking about like. "What can I charge to clients?" This is a question you'll also see in social media. You and I see the social media groups a lot. These days it's Facebook, it used to be LinkedIn, we basically met on LinkedIn. People ask that constantly. No one, of course, has a solid answer. Of course, we can't actually discuss our actual fees in these public media because of antitrust laws and the way the insurance companies really don't want us to do that. So, let's be careful about that piece, but how do you determine what someone's revenue goals should be? Like, if you're going to help someone with that, which I know you do, what do you talk them through in order to figure out the answer to that question?  
Rob: Well, that piece can be a consultation all in and of itself, but the basics are to look at things like, what do you personally ... Again, it depends on whether you're a solo practitioner or a group, it can look very different. Well, let's just say you're a solo practitioner. You need to look at what revenue do you feel you need to be bringing in to maintain the lifestyle that you are establishing for yourself. To be able to house yourself, and feed yourself, and purchase health insurance, factoring in how many hours you want to work. How many hours can you work with clients while still allowing yourself self-care. I've heard of people seeing 40 clients a week and I'm always baffled. They obviously have much more stamina than I do, and I'm in pretty good health and I'm an athlete.  
I just can not, I can't [grock 00:07:12] doing forty-  
Roy: Yeah. You are, yeah.  
Rob: ... client sessions a week. So, that's another thing. When I analyze things for myself.  
Roy: I can't either. I really can't.  
Rob: ... I can't say, "Oh, well, I need to work as many hours, I have to work 40 hours to make my revenue." It wouldn't work for me.  
Roy: It sounds to me like we got a useful formula here, though. You had mentioned, how many sessions can I do in a week? We know that sure has a lot to do with stamina and-  
Rob: How long the sessions are.  
Roy: ... the [crosstalk 00:07:39] you use. Oh, right, right, I guess you say how many hours, because we're talking about income-  
Rob: Right.  
Roy: ... so how many units of work, or something. Most of us, by the time we get into private practice have gotten a pretty good idea of how many clients we can see in a week before it's exhausting.  
Rob: Well, I know a lot of people that start in other environments, like agencies, forcibly find out how many hours that they can handle, because you have quotas and all kinds of fun things like that.  
Roy: Yes, exactly, you're right. It seems to me that if you could figure out what that number is for you, and then you also find that other number, which is how much money you need to earn to pay all the bills, and save a certain amount of money, then from there it's just arithmetic to figure out how much you need to charge for every one of those sessions each week.  
Rob: Yeah. The tricky part comes again because so many in private practice don't have that business background. It's making sure you're really including all the factors in the amount of revenue you have to have. So, not just overhead-  
Roy: Yeah.  
Rob: ... of what is your rent for whatever office space you're using, and things like that, but also things like having a contingency fund, planning for the unexpected, knowing how much you might invest in marketing and growth.  
Roy: Yeah.  
Rob: Maybe you are a solo practice and you're thinking, "Hey, I eventually want to grow into a group." Well, there's going to be incurred expenses as you try to make that expansion, and having a plan for that.  
Yeah, once you can factor all those things in and come up with that rough estimate revenue number, then you can do that math.  
Roy: What if the math shows that I need to earn more per sessions than any of the insurers in my area will pay?  
Rob: Well, then, you have to think about, "Okay, maybe I'm not going to be taking insurance, maybe I need to investigate-"  
Roy: Rob, how can I possibly get clients if I don't take insurance?  
Rob: Marketing, yeah. Lots and lots of marketing and establishing solid referral networks.  
Roy: Okay.  
Rob: Again, it's not that simple. I know that sometimes we read things that make it sound simple, "Oh, you can do private pay, anybody can do private pay," I don't necessarily subscribe to that. I think there's a lot of factors that go just into that decision. What are the socioeconomics in your area? How many people in your area have and rely on using their insurance benefits? That's certainly part of that decision. "Okay, insurance isn't going to pay me enough. Does that mean I'm going to have to look at working more client sessions? Is it still going to be within the realm of how many I feel like I can do and maintain good self care? Or, do I look at what it will take to do a private pay practice and maybe there's some other ways I can bring in revenue," whether it's running groups or doing some contract work with someone or branching into telehealth. That's where it gets kind of complicated. Yeah, the basic formula is pretty straightforward, but all the different pieces that might go into it take a good bit of time and evaluation.  
Roy: Right. Yeah, I'll agree with that. Also, don't forget, tax withholding.  
Rob: Yeah.  
Roy: The fact that it's hard to figure out what to withhold.  
Rob: That's another one that I think people often get a quick lesson in if they work for somebody else's group practice, they go in as a contractor.  
Roy: Right, and they forget that that means that getting paid the pretax income and they got to figure that out.  
Rob: Yes, I've run into many who didn't realize until tax time that, "Oh, wait. I was supposed to be paying estimated taxes or saving some money to pay taxes at the end of the year."  
Roy: Right. Here's another thing, and this, actually, I've seen colleagues run into this even who are pure insurance based, because they'll really get the clients in and they'll have plenty of work. Do look out for the moment when you know you're pretty sure your tax rate is X, maybe you figure it's about 20%, and then suddenly you start making the kind of money that actually a therapist who's working a lot can make, and you go into the next tax bracket. Suddenly, you actually need to hold more than you realized. I don't just mean the self-employment tax. I mean, suddenly, just your income's a higher tax bracket. You'll notice, if you've never been a big earner, which most of us haven't, that you don't have to earn a ton to get into a new tax bracket. I got bit by that before as a counselor, when I was a still a developer and I ended up having to put like 5,000 in taxes on a credit card. [crosstalk 00:12:00]  
Rob: Good times.  
Roy: Yeah, which, by the way, don't do that, because actually the IRS will give you a much better repayment terms than a credit card will, but I didn't know that at the time, I was young, I was stupid.  
Rob: [crosstalk 00:12:10] Naive. Naive is the word, not stupid.  
Roy: Naive is the word. Naive, yes, that's right. Yes. Well, my thought was actually, maybe I should actually figure out what my tax rate is.  
Rob: Yes.  
Roy: Or ask an accountant.  
Rob: What, you wanted to be proactive, and plan, and be prepared?  
Roy: Yes. I did. Actually, that was a hard lesson I learned, I started being self-employed when I was 22, right out of college. Since then, I've only been employed for three years, when I worked in Japan, and like three months, working at Trader Joe's. That was fun.  
Rob: I didn't know that.  
Roy: Yeah. They're a good employer, actually. Other than that, I've always been self-employed. I early on learned those hard lessons that you can really run into some annoying or damaging pit falls, pit holes, pit falls, if you don't plan ahead, right?  
Rob: Yes.  
Roy: If you don't be aware of, how much tax do I have to pay? What does it actually mean when you say something is a business expense? Or people say, write off, a lot, which is not actually the correct term, but that's fine, it's not a big deal, as long as you understand what it means.  
Rob: Right.  
Roy: When you spend 50 bucks on something that's a business expense, it doesn't mean you save $50 in taxes.  
Rob: Right.  
Roy: It means you don't pay taxes on $50, which is great.  
Rob: But that's also $50 you don't have in your pocket.  
Roy: Exactly. Right. If your tax rate is 25%, that means you've saved 12.50, not $50.  
Rob: Right. Right.  
Roy: Things like that. Those are the kinds of stuff that is I think important to understand. I often see on social media people often get confused because they've jumped in with both feet before understanding those things, which is not good or bad, but just [crosstalk 00:13:44]-  
Rob: Not only did you only save the 12.50, but you also don't have that 37.50 in your pocket that you would have had.  
Roy: Yes. Precisely. Yeah, exactly. Yeah, I'm with you.  
Rob: So you're saying that I can't just spend every piece of revenue on business expenses and then that'll work out for me, because I won't have to pay any taxes?  
Roy: Yeah. Well, you wouldn't have to pay any taxes, that's true. You still have to pay rent, usually, but you wouldn't have to pay any money for it, so you might be in trouble.  
Rob: That's a little bit of hyperbole there.  
Roy: Yeah, a little bit of a hyperbole. Also, when people say, "Oh, it's a tax write-off," I always find that funny because to me, I'm like, I know what business expenses are, I don't need to be reminded of what's a business expense.  
Rob: Right.  
Roy: If someone says, "Oh, it's a business expense," I'm like, "Yeah, I've already done that math."  
Rob: It's kind of akin to people go out and buy items on sale and say, "Oh, but I saved 30%."  
Roy: Right, right, exactly.  
Rob: Yes, but you could have saved 100%.  
Roy: Right, by not buying it. Right, yeah. This is true except for when we run a sale at Person Centered Tech, at that point-  
Rob: Absolutely.  
Roy: ... you should buy it because you're saving money. Absolutely.  
Rob: You said some key words in there-  
Roy: Otherwise, no.  
Rob: ... that we kind of highlighted at the beginning and I want to wrap it back around to being proactive and planning.  
Roy: Yeah.  
Rob: All the things we're talking about today are about proactive and planning, not waiting until this thing hits you like a Mack truck that, "Oh, wait, I should probably have thought about this before and planned for it." Which brings us to-  
Roy: Right.  
Rob: ... another piece. I've kind of hinted at it, marketing, being one of those pieces.  
Roy: Yeah.  
Rob: One of the un-thought about unseen pieces of marketing is brand marketing and more specifically, your online reputation and how that affects your brand marketing.  
Roy: Online reputation, okay, yeah, now we're getting into some big area. When we had our social media ethics episode-  
Rob: Yes.  
Roy: ... [Keeley Kolmes 00:15:34] was alluding to that. Yeah. There's a lot going on there.  
Rob: Yeah, there's a lot to pay attention to and a lot of things that can affect your online reputation. This might be a topic that we should bring somebody in who really has some expertise in it.  
Roy: But who could we find that has such expertise in that kind of thing?  
Rob: Who could we find?  
Roy: Whoa, someone's at the door, Rob.  
Rob: Oh my gosh, it's Tamara [Suttle 00:16:01].  
Roy: Oh, sweet.  
This episode is brought to you by Hushmail, your secret to super simple, secure communication. I have actually been a follower of Hushmail since about 2000, they were one of the first companies to start doing secure email and using encryption email, and that's actually why I picked up Hushmail for my own practice when I started. I should say, I actually consult for Hushmail now, which is both a disclosure, but also lets me know that they have a whole roadmap of things they plan to do, especially for the mental health community, and so I'm pretty excited about that.  
Rob: Yeah, I've been using Hushmail ever since I started my practice in 2007. One of my favorite features, I really love that I can have an encrypted, secure contact form on my website.  
Roy: Yeah. Yeah, the contact form is exactly how I do most of my initial contact with clients and that's a Hushmail form.  
Rob: I've gotten so many positive comments from people because they appreciate that I am that serious about their privacy and confidentiality.  
Roy: Hushmail is also offering 15% off for life to our listeners, just go to Tech, and you can also find that on the show notes page. That's Hushmail, your secrete to simple, secure communication.  
Rob: All right, we're very lucky to have with us today, Tamara Suttle, who lives in the wonderful state of Colorado where it's very chilly right now, I have to assume, right, Tamara?  
Tamara Suttle: Yes, it is, snowing outside.  
Rob: Tamara is an LBC, I believe you're licensed in two states, Colorado and Texas. You're an approved supervisor, you've been in mental health for about 1,000 years-  
Tamara Suttle: Watch it.  
Rob: ... you were kind of a pioneer for starting up a community supporting therapists with your blog and helpful articles about, "Hey, how do you run a private practice," right? Private practice from the inside out.  
Tamara Suttle: It is true. It is true. I was hungry for connections. I just moved to Colorado and I need some connections, I needed a community, so I thought you guys might do.  
Rob: Awesome. You provide therapy for therapists and coaching for people, and all kinds of wonderful things.  
Tamara Suttle: I do.  
Rob: We're really lucky to have you on because I think you have a lot of wisdom to share about what we're talking about. One of our list items of things people should be focusing on in the new year, and that is managing online reputation.  
Tamara Suttle: Yep, I talk to people every single week about that and the problems they run into with not doing that.  
Rob: What kind of problems?  
Tamara Suttle: Oh gosh, I've got a colleague/friend in Texas that about 20 years ago was seeing a couple, high conflict, they weren't sure they were going to make it, the husband wanted to make the marriage work, the wife wasn't so sure. They went to see a therapist, the therapist was in an office with a psychiatrist, a nurse practitioner, and she herself was a psychologist. They went through some therapy, the wife decided to leave, the husband got mad at the professionals, and for now, almost 20 years, he has blogged religiously about all the problems with that psychiatrist, that nurse practitioner, and that psychologist, and there's not a darn thing they can do about it because he catches everything in terms of, "In my opinion." That's just one example.  
I've talked to a lady in Georgia who divorced her husband, he was mad at the settlement, he now has gone to every single review site, I think, he can possibly find to slam her professionally under aliases, so that there's nothing they can do about that. I can go on and on and on.  
Rob: Okay, those are rough ones.  
Tamara Suttle: Yeah.  
Roy: Yeah, I don't think I want you to go on, and on, and on.  
Rob: I know, I'm scared.  
Roy: Usually, I'm not the one who's scared, I'm usually the one scaring other people. Tamara, what are you doing?  
Tamara Suttle: You're in luck, I'm not going to talk to you about what to do when you get cyber slammed by your client tonight.  
Roy: Okay. Okay.  
Rob: You've kind of already given us a part answer to the first question which we were going to ask, which is, why is it so important to manage your online reputation?  
Tamara Suttle: Gosh, well, think about this, I've been in the field about 30 years now and think if I've spent 20 or 30 years building my reputation, and it takes five minutes to lose my reputation. Back in the old days, I don't know that you guys are this old, but back in the old days, in the 90's, when I started in private practice, you had a phone book to market your practice and you had a lot of cold calling to market your practice, for the most part. Now, we have the internet and it's been around for a good chunk of time now that therapists have been online, and we all, even if we don't have a website up, we almost always have an online presence. If you're not tending to it, if you're not paying attention to it, it doesn't mean you don't have an online reputation, it simply means you're not tending to the baby and the baby may come back to bite you in the butt.  
Rob: Wow, yeah.  
Roy: That doesn't sound pleasant.  
Tamara Suttle: Okay, so that's the unpleasant side. The positive side is, you've got an online reputation and it can do wonders for you, as well.  
Roy: Right. I've got to throw out this question because it's something that comes up pretty frequently is ... Okay, I'm going to go ahead and give it the most naïve way possible, you just [inaudible 00:21:15]. What? What's so bad about that? What's so bad about the husband in a former couple blogging negative things about me every day for 20 years?  
Tamara Suttle: Yeah. Okay.  
Roy: That one's obvious, but please, tell me what you think.  
Tamara Suttle: There's a lot of problems with that. When you think about word of mouth, the most trusted kind of feedback that can be given about you, is general old word of mouth, whether it's online or off, it's the most trusted type of feedback. It is light years more trusted when somebody says something about you and your practice, or your professional reputation, that's much more trusted by the general public than when we talk about our brilliance. If you think about how much faster that word of mouth travels now because we're online, and fact-checking doesn't really happen-  
Roy: Right.  
Tamara Suttle: ... so whether it's a review site or a comment that somebody makes on Facebook in passing, or anything that is stated about you online, has the potential to be great for you or really suck.  
Roy: Right.  
Rob: Good point. You're saying that when I say, "Why does it really matter?" You're saying, "Well, it does matter, people see that."  
Tamara Suttle: Absolutely. I'm also saying that 74% of consumers say that if there is a positive review online about a business that their trust automatically goes up in that business, so it can work to our advantage, as well.  
Rob: Right. I also know, I've seen this, I don't have any numbers about it, but there's also been a lot of talk from experts about how if you have positive stuff, a little bit of negative stuff makes the positive stuff more believable.  
Tamara Suttle: It absolutely does, there's lots of marketing research out there to support that. The flip side, if the only things said about you is grand and glowing, especially on the review sites where it's quantified, if the only thing there are five stars and nobody ever gives you a four, or a three, or a one, that's not very believable and the general public finds it highly suspicious. [crosstalk 00:23:14]  
Rob: Even as simple as buying something on Amazon-  
Roy: Right. Yeah.  
Rob: ... and if that's all you see is the five star ratings, you think, "Okay-"  
Tamara Suttle: Exactly.  
Rob: Right.  
Tamara Suttle: Like a book review, yeah.  
Roy: Yeah. What we kind of hear from that is that your online reputation isn't just a simple matter of, make sure it's all good. It actually is kind of complex, right?  
Tamara Suttle: Exactly. It is complex.  
Rob: What are maybe the top three things that mental health clinicians can do to manage that reputation then?  
Tamara Suttle: The first thing is, you need to own that it is exists and monitor it. If you're not out there monitoring what's going on about you, if you don't know how, if you don't know where to monitor it, then there's not really anything you can do until after the fact, and that's not necessarily a good thing. You need to be monitoring everything from your blog and your blog comments, to other people's blogs and their blog comments, and Facebook, and Twitter, and Pinterest, and review sites, and anywhere else that your name might show up.  
Rob: So you just spend all day on the web.  
Tamara Suttle: No, I do not. I don't mind having the appearance that I stay online all day, and I don't mind that other people think that about other therapists, either, I know that, that's not really true. One of the simplest things you can do to monitor your online reputation is just go to Google Alerts. It's a free service, you sign up for it, you can put every variation of your name and every variation of your business name into Google Alerts, and good old Google is so nice, they just send you a little email once a day, or however often you want it, letting you know that somebody said something about-  
Rob: Yeah.  
Tamara Suttle: ... with a link. Then you can go back and decide what you want to do about it.  
Roy: Okay. Let's say I get a Google Alert that tells me that someone mentioned me in a review, like maybe it's a Yelp review that mentions me, I go check it out, and let's say it's somebody who I'm pretty sure is not my client, or I'm not sure because they're using a username, I don't know who actually it is.  
Tamara Suttle: Exactly.  
Roy: They make some reference to therapy, but they're not really saying anything that seems to imply to me or helps me understand who this actually is.  
Tamara Suttle: Yeah.  
Roy: I'm pretty sure that maybe they're not my client or maybe they're that family member of a client that I know hates me.  
Tamara Suttle: Or maybe they're a colleague that's rating you.  
Roy: God, gah, that's terrible.  
Tamara Suttle: Yeah. [crosstalk 00:25:37] And may have said you rock. I've gone out-  
Roy: Oh, sure.  
Tamara Suttle: ... to review sites and left glowing remarks about other therapists.  
Roy: Right, which is actually ethical. It is ethical for us to talk to each other about doing that, as long as we're open and honest about what we're doing.  
Tamara Suttle: It absolutely is. I will say, "I am so-and-so's colleague, I've known her for this amount of time, and what I love about referring to her is I always know she takes care of her clients."  
Rob: Yeah, there you go.  
Roy: When [Keeley 00:26:05], Keeley [Kolmes 00:26:05] came on here, she mentioned that she's done consultation for people who've had colleagues come on and slam them.  
Tamara Suttle: Absolutely, that's most of who I end up talking to, either colleagues or somebody else.  
Rob: When it's been colleagues, has that generally been a competitor or have there been other motivations for that?  
Tamara Suttle: Well, in the first place, it's not always easy to tell if it's a colleague. You, as an individual, might have a gut reaction and know, but they could have used an alias, they could have said there anonymous. I've never seen a colleague say, "I'm so-and-so's colleague and she's unethical, and she sucks."  
Rob: Yeah, okay. Okay.  
Tamara Suttle: You may be 99% sure, but it's very difficult for you to be 100% sure.  
Roy: Yeah. It's funny, I've only heard of that from you and from Keeley Kolmes. I have not heard people ... People have not reported that one to me.  
Tamara Suttle: I've heard therapists suspect that, strongly suspect it, know that they've offended some other therapist or bent some other therapist out of shape-  
Roy: Right.  
Tamara Suttle: ... and so they believe that they believe that they believe it.  
Roy: Wow. Yeah, okay.  
Tamara Suttle: I don't know that you could ever prove it.  
Roy: Right. I should say that going onto a review site and slamming a fellow therapist is technically not ethical.  
Tamara Suttle: You think? I would say it's beyond that, it's immoral.  
Roy: Yes. Right. Okay.  
Tamara Suttle: I follow this physician, his name is Howard [Lucks 00:27:24] and sometimes I quote him, he says, "You can't control the conversation, but you can be part of it." Certainly, in a review site, there are lots of things you can do, ethically, and then there's some things that you definitely can't do. If a colleague or someone that you believe to be not your client, is offering a negative review, you definitely do not need to ignore it, whether it's on Twitter, a review site, in Facebook, or anywhere else.  
Roy: Yeah, that's definitely the case. With a colleague or non-client, if it's clear they're not a client, yeah, there's no right of confidentiality. That's the main thing that makes it hard for us to respond to it when it's a client or someone claiming to be a client, is confidentiality prevents us from being able to do a lot of the usual stuff we do-  
Tamara Suttle: Absolutely.  
Roy: ... when there's a negative review.  
Tamara Suttle: Absolutely.  
Roy: If it's a colleague, there's no such thing.  
Tamara Suttle: I have to say that I've talked to some therapists who have been on the receiving end of their client's or former client's negative reviews, and it has had some devastating results. Not necessarily because it has killed their business, but because depending on the therapist and the level of experience of that therapist, it can be a devastating blow to them, just their confident.  
Roy: Yeah.  
Tamara Suttle: I have a very dear friend here in Colorado who as a young clinician trying to get her supervised hours in, to get her license, she did not have a very good supervisor, and her supervisor did not really pay attention. The new, fresh grad out of school was seeing a client, documented something in the chart, in a way that was not an appropriate way to document it. The supervisor didn't read the progress notes, so did not correct it.  
Roy: Wow.  
Tamara Suttle: The client actually lost custody of her children-  
Rob: Oh no.  
Tamara Suttle: ... the young therapist had no idea any of this was going on, she didn't know she'd done something wrong. She ended up having what she thought was a successful run with this client, and a year afterwards, when the new therapist had moved on and was now freshly licensed, got a request for the client's records. Therapist turned over the client records, the inappropriate comment in the records went before the court, the court said, "Based on this comment, client loses kids," and only then, when the former client reached out to the therapist, only then did the therapist realize that there was an issue. Of course, there was nothing she could do, and the former client got upset, left a horrible one star rating on the review site, and the therapist was devastated. The client had lost her kids, custody of her kids, two, the supervisor didn't supervise, that was just about the worst thing that could happen, that didn't-  
Rob: Right.  
Tamara Suttle: ... at all affect the success of this therapist in the long run, but her ability to rebound from that and not feel extreme shame about getting a one start rating, a year out of college, it's just sad.  
Roy: That is really sad. That is a really sad story, yeah. What she need is some other reviews to balance it out.  
Tamara Suttle: Exactly and some lived experience to understand that we are all going to have clients who are not pleased with us at some point. If you stay in this field, for a variety of reasons, we're not going to be a good fit for everybody, we're not going to always do our best work, we're going to make mistakes.  
Roy: Right. This sounds very similar to stories you hear, I'm going to reveal a little bit about what kind of podcasts I listen to, on the Savage Love podcast with Dan Savage. My wife listens to it, it's not me, I just overhear it. He talks a lot about what happens when people say something on Twitter or Facebook, or like a public Facebook profile, when they're 21 years old-  
Tamara Suttle: Yes.  
Roy: ... and how it comes back when they're 30.  
Tamara Suttle: Yes.  
Roy: He's like, "We have to societally change this. As a society, we have to allow people to be dumb in a context that is archived."  
Tamara Suttle: Absolutely. We need to have enough compassion for each other and understanding of where they are. The context is everything.  
Roy: Exactly. Yeah, I'm totally with you. If it wasn't on Twitter where you can go back and look at it now as if it just happened-  
Tamara Suttle: Yes.  
Roy: ... because it looks like that.  
Tamara Suttle: Yes.  
Roy: You wouldn't care what they do when they're 21.  
Tamara Suttle: That's right.  
Roy: Now, you're like [inaudible 00:31:50] maybe they said this thing, so that must reflect what they are now.  
Tamara Suttle: That's exactly right.  
Roy: That's not fair. It sounds like this person basically ran into an equivalent that and it's not fair.  
Tamara Suttle: Yeah.  
Roy: Yeah, wow.  
Tamara Suttle: That's the first thing I do. You're asking for three, but that's the first thing I would-  
Roy: Yeah.  
Tamara Suttle: I would conduct that online audit and monitor what it is that's going on with your name.  
Roy: Right.  
Tamara Suttle: The second thing I would do is, you need a plan, you need to figure out what needs to be cleaned up online about you and what needs to be highlighted because it's fabulous and we want more people to hear it. You need to figure out that whole plan about how you're going to clean up and celebrate, really, the stuff that's there.  
Roy: Right on. That sounds good. How do you do that? Out of curiosity, how do you celebrate the stuff that's there?  
Tamara Suttle: I share it and I try to get other people to share it, if I can do that in an ethical way. If somebody has said something fabulous about me-  
Roy: Sure.  
Tamara Suttle: ... then I am grateful. First of all, I'm going to send them a note and say, "Thank you," right?  
Roy: Right.  
Tamara Suttle: Because I want to encourage you to say it again. That's the truth.  
Roy: Right.  
Tamara Suttle: If you're writing nice things about me or you're saying nice things about me in the Rob and Roy show here, then I appreciate that. Sometimes it's shareable, literally repost it in Facebook or retweet it on Twitter, or pin it on Pinterest, all of those things-  
Roy: Yeah.  
Tamara Suttle: ... get passed along again if the content is good.  
Roy: Yeah, that's true. I obviously monitor my reputation, I'm sure Rob does, too, at least through watching what comes up on Google. In my case, I've got a big advantage that the first 20 bazillion pages of Google are full of stuff that I produced-  
Tamara Suttle: That's not bad.  
Roy: ... or [crosstalk 00:33:37] somewhere. Yeah.  
Tamara Suttle: That is definitely not bad, Roy.  
Roy: Yeah, it's pretty good.  
Tamara Suttle: Yeah.  
Roy: It's pretty good, yeah. That comes up because for me, and this is the thing I tell people a lot is being like, if there's something negative about you there, having a lot of positive then gets you that golden ratio earlier of-  
Tamara Suttle: Absolutely.  
Roy: ... a little bit of negative, a lot of positive, and that actually makes the whole thing look a lot more realistic and good for you. I find when I mention this to audiences, a lot of people are like, "I'm not really big on social media, I don't want to spend a lot of time creating web content." What do you have to say that?  
Tamara Suttle: Well, you know what I would. I know you know.  
Roy: I know what you're going to say, I wanted to get you to say it.  
Tamara Suttle: Let me just say that you're talking about the third thing to do, to manage that reputation, and that is to be proactive. Because you've generated all this fabulous content, either in video, or podcast, or by text, in some way it really does push down and dilute whatever negative stuff might be out there about you. I think it is naïve. I think that not everybody has to be out there blogging, it is certainly, in my opinion, the easiest and fastest way to build a good reputation online. If somebody has really blown you up in a negative way online, I would tell you, you are foolish to not do that, but I would also that I totally get that you didn't get your master's or doctoral degree and license because you wanted to sit behind a computer all day. So, I would say, to the extent that you're able, you need to be generating fresh content about you, but there are lots of ways to do that. Blogging, to me, is the easiest, but you could also get out there and get interviewed by other people.  
You could also get out there and maybe you're artistically inclined, but you don't want to blog, so you could use, perhaps, your artwork to get out there. You could engage in other people's websites in whatever they are posting, engage in conversation that way, as well. Whether that's commenting on blogs or engaging in Facebook or Twitter content. The reality is, as a solo entrepreneur, if we're not intentional about our online presence, if we're not being of service to others and being sensitive to their struggles, and finding ways to support them, if we're not connecting with other people online, then the online reputation you have or don't have is really all about you. If you choose to turn your back and just let it take care of itself, you can't expect much, not for the long term.  
Roy: That's really well said and I'm totally with you there, yeah.  
Tamara Suttle: Your professional reputation and your business reputation are only as good as your online search results. If nobody can find you, if nobody's ever heard of you, you're not going to have a great online presence. It might not be negative, but it's probably not serving you.  
Roy: Well, more and more, no presence is a negative presence.  
Tamara Suttle: Absolutely.  
Roy: People, that's what they look for. If they get a referral for you, they're going to look for your online presence to kind of followup on the referral.  
Tamara Suttle: Absolutely. If there is none, then people don't find you to be credible as a business professional these days.  
Rob: We started out talking about managing online reputation, but if I'm understanding you right, maybe a more appropriate word is curating your online reputation.  
Roy: Nice. Nice.  
Tamara Suttle: Nice. Yeah.  
Roy: Yes.  
Tamara Suttle: Absolutely.  
Roy: TM. Tamara Suttle, the online reputation curator.  
Tamara Suttle: I think what can be said is that when you think you're offline, you're not. You're not.  
Roy: Now, that sounds scary. That sounds like something Rob and I tell people. Well, so how do you ... No, I want to ask how you help people, Tamara, because I know you do, but I think Rob has a question for you first.  
Rob: I think it's time.  
Roy: I think it's time.  
Rob: I think it's time for the super random, pull out a card from the describe deck question.  
Describe comes with over a dozen activities that can be used with clients of all ages. Find out more at  
Are you ready?  
Tamara Suttle: Yes. Yes. Yes. I love this. Yes. I'm ready. I'm nervous. I'm nervous, but I'm ready.  
Rob: Everybody says they're nervous, I find that interesting. I know, it's funny.  
Tamara Suttle: Let me tell you something. I know you guys don't know this, I don't know, maybe you know this, but do you know that I use this as an example of a really brilliant way to organically market your product? Do you know I do this, Rob?  
Roy: What are you talking about? Who's marketing a product here? No one's marketing a product, what are you-  
Tamara Suttle: Stop.  
Roy: Product?  
Tamara Suttle: Come on, guys, it's time to own it. Come on. I think this is the most brilliant thing because I love your deck. I love your deck, Rob.  
Rob: Well, thank you. I really appreciate you were one of the original people that backed it when I put it on Kickstarter.  
Tamara Suttle: Well, it was so exciting because there was really nothing, there still isn't really anything like it out there, and it's such a useful tool. Not just for therapists, it's like every parent ought to have this deck on a road trip. Every parent ought to have it. There's so many other applications. I think writers and bloggers ought to have it because it can feed your brain in so many different ways, so I am forever talking to therapists about how to more organically market their services and their products. When I talk about products, I use this as an example because you've just integrated this so beautifully, no high pressure, it's not sales-y pitchy, and you're right, most of your audience probably didn't even know that, maybe, that it's yours, but I love it. Yeah, give it to me.  
Rob: All right. I appreciate that you said it would be great in the car, it even beats out license plate Bingo?  
Tamara Suttle: Yes. Yes. Which I love, by the way.  
Rob: All right, so you are you ready?  
Tamara Suttle: Absolutely.  
Rob: All right, today's word is important. Tell us about a time when you felt important.  
Tamara Suttle: Good question. I guess, even though this is ... I've been accused of connecting the dots in strange ways before, so I don't know if this is going to work for you guys. Here's what comes to mind. When you say importance, I realize that times I've felt important are often also the times I've felt most humbled. A couple come to mind like when I've done some amazing work with a client and they are in awe of what they've just figured out. I feel both very honored and humbled, but I also feel like I was an important part of helping facilitate their work, and that is a totally cool thing that we all get to experience, right?  
Rob: Yeah. Yeah. Absolutely.  
Roy: Absolutely. I'm totally ... I can identify with that one quite a bit.  
Tamara Suttle: Then the other one that comes to mind, because I'm wordy, is I hadn't been blogging for too long, less than a year, and nobody in Colorado really knew who I was when I first started blogging because I was fairly new to the state. We didn't really have therapist communities in this state back then. I had just started blogging earlier in the year, went to whatever the national conference was I attended after that, was in the vendor section just walking up and down, looking at the tables of stuff, and this professor from the University of Texas in Austin was sitting behind the table manning their vendor table. I walked up and asked a question about something maybe related to their program, I don't even remember what it was, and she saw my name tag and she jumped up out of her chair, and she ran around the table, and she said, "Oh my gosh, you're Tamara Suttle-"  
Roy: Oh, wow.  
Tamara Suttle: ... "oh my gosh." She recognized me from my blog. By the time she quit squealing, there were like 40 people standing around because she had created such a scene and lots of those people recognized my name. They didn't know me from Adam's house cat, but they recognized my name from less than a year of blogging on a weekly basis.  
Rob: Yeah.  
Tamara Suttle: That was both humbling and affirming, and for a second it was like, "Wow, I guess ..." Maybe important is the wrong word, but recognizable comes to mind as being maybe more accurate than important, but it was a cool experience.  
Rob: Well, you're obviously having a positive impact for them to have that reaction.  
Tamara Suttle: Yeah. Yeah.  
Roy: Yeah.  
Rob: Awesome.  
Tamara Suttle: Yeah. What a cool question though, thanks.  
Roy: Okay. This is really a lot of fun, we probably should have Tamara on, just do an entire episode together.  
Tamara Suttle: Just because I talk a lot.  
Roy: Well, we really like talking, it's really fun to hang out with you, Tamara. I want to say, before we even started recording, Tamara was already giving us marketing advice, really good [crosstalk 00:42:24], she always does. Every time I see Tamara, she's got promotional marketing advice.  
Tamara Suttle: Unsolicited advice, whether you want it or not.  
Roy: Well, Person Centered Tech has done a lot of things based on advice or help from Tamara Suttle-  
Tamara Suttle: Thanks.  
Roy: ... and it's absolutely the case. There's a number of big successes we wouldn't have had if she hadn't advised us. I want all of you to get the same thing, so Tamara, how can people get the help that we've gotten from you?  
Tamara Suttle: My website is and if you show up there, you'll find my blog, Private Practice From the Inside Out, there's freebies, there's lots of information, and then your audience is such a rocking audience and is growing so quickly for you guys, if it's okay with you, I'd like to send you a downloadable little link of bread crumbs to leave, to build your online reputation. Do you think they would like that?  
Roy: I'm sure they would, yeah.  
Rob: Don't you have ... This is something you've been doing for quite a while and certainly plays into what you were talking about, don't you have one of your blog start things coming up soon?  
Tamara Suttle: Yes. I'm so excited, I've been doing this for eons it seems like, twice a year, thank you for asking, that's sweet of you. Twice a year I offer a four week little course on blog start for therapists, it's really geared for therapists who have a blogging platform on their website already and don't have a clue what to do with it. So we start at the basics and we talk about everything from the do's and don'ts ethically and legally for blogging, and how to put a plan in place, and how to get people to your website because of course, a lot of people start a blog and then they feel like they're blogging out there to crickets and nobody's engaging with them or leaving comments. So, we talk about how to get people to your blog and keep them coming back.  
Rob: Exactly.  
Roy: That also sounds like a very useful thing for people who want to manage that online reputation, or curate it, as [crosstalk 00:44:20]-  
Tamara Suttle: Absolutely.  
Roy: Right.  
Tamara Suttle: We actually start that in January. In addition to that, can I just throw out one other thing that's a freebie, free webinar coming up in January?  
Roy: Throw it.  
Tamara Suttle: I'm doing a promotional little webinar called, How Your Cringe worthy Blogging Mistakes Are Costing You Clients.  
Roy: Dang.  
Tamara Suttle: It's free, anybody can come to that, so you'll find all that information on my website now or soon.  
Roy: That is great. That all sounds like really actionable, useful stuff, so I think everyone should check that out. By the way, you mentioned that your blog starter is for people who already have a blogging platform on their website-  
Tamara Suttle: Yeah.  
Roy: ... that's pretty technical language, I think a lot of people may not realize that they actually apply to that. If your site's made with WordPress, you have that, so I just wanted to make sure everyone knows that.  
Rob: Yeah. Even if it's on a lot of the other sites where you build it yourself, most of them have that capability, as well.  
Tamara Suttle: Absolutely. You guys know that you are my tech gurus and you know that I know nothing about technology, I'm a wizard on the front-end, but I'm clueless on the backend. Which is why I ask people to have their blogging platform already set up.  
Roy: Yeah. So, your tech gurus can assure everybody that, that's actually not hard for them. May of them have that ready to go, they just need someone to tell them how to use it.  
Tamara Suttle: Excellent. You guys, than you so much. It is such an honor, really, there are lots of podcasts out there and I really want to say that not all podcasts are equal and don't get me wrong, I'm not slamming my colleagues at all, but I think there is nobody, nobody out there offering the quality and depth of tech info that you guys are offering to therapists, and making it so palatable. You make it not scary for me and you make it not scary for my clients, and for that, I love you both. Thank you.  
Rob: Well, we love you, too, Tamara. Thank you very much for saying that, because that's been our goal all along.  
Roy: Right.  
Tamara Suttle: You're rocking it.  
Roy: Thanks. Right on. Well, thanks for being here. We wish we could talk longer, but I think it's about time to sign off.  
Tamara Suttle: That's what I always hear. Bye guys.  
Roy: Bye Tamara. Man, I love talking to Tamara, I always get so much good info from her, every time I talk to her.  
Rob: Oh yeah, she's a fountain of solid information, not only about what we were talking about here, the online reputation, but about blogging and many other things having to do with private practice.  
Roy: Yep. Totally true. Okay, I have a thing I want to talk about, Rob.  
Rob: This is great, good. What do you want to talk about, Roy?  
Roy: In 2018, I want to talk about whether or not you should try to do tele-mental health.  
Rob: Whether or not I should? I'm already doing tele-mental health, Roy.  
Roy: You, our general audience, I mean.  
Rob: Oh, I'm sorry, I keep forgetting there's people out there listening to us. Okay, yes, the general audience.  
Roy: The royal you. The royal you.  
Rob: I have to imagine that many of the royal you out there-  
Roy: Yeah.  
Rob: ... contemplate getting involved in tele-mental health. What guidance do you have for them, these people that are thinking about it?  
Roy: Well, there's a couple ways to look at it. When I say, "Do you want to get into tele-mental health," but there's kind of two things that could mean. One is, do you want to start offering that as an adjunct for your existing clients? In the sense of like, when they travel or if you're considering what might happen if a client moves into a different part of your state, or I guess into another state where you're licensed, or can get licensed, seeing if you want to say to your clients or make it possible for your clients to continue seeing you online. If you want to set that up, offer that as part of your practice.  
The other is whether you want to hang a shingle and open up a tele-mental health practice. I think it's a good idea because our office hours people, like our members, have been asking about this more and more and more, and it's becoming a bigger deal. So, I thought I might kind of give what we've discovered, talking to them here, in the next few minutes.  
Rob: To be clear, that second option, where you're talking about hanging your shingle, you're talking about solely and exclusively providing tele-mental health services, you don't have an office, nobody's coming in to see you, is that's what you mean?  
Roy: Not necessarily, so thanks for asking. What I actually mean by that is, there's a difference between transitioning in-person clients to online versus going out and forming therapeutic relationships with new clients purely online, with the expectation that they may never see you in person.  
Rob: Exactly.  
Roy: Although standards indicate that it would be good if you can see people in person on occasion, but certainly other experts have talked about how weird that is, that's a whole other thing. Certainly, that's a thing, is just hang a shingle as someone who establishes relationships and continues them purely online. That's what I mean. You can do that in addition to your in-person because I know that's what you and I do, right?  
Rob: Yes.  
Roy: Yeah. Yeah, that's what I do, I have both. There's the question of, do you want to set up that second one? Or do you just want tele-mental health to be a medium that's available to your existing clients? Either way, there's setup involved.  
Rob: Gotcha. Good clarification.  
Roy: Yeah. Thanks. Well, good question. I did not think to clarify it. The thing I would say for the first one, do you want to offer it to your clients? A lot of people do that in response to a client asking about it. That can often be just fine. My experience, and there might be some pundits or experts out there who are going to chafe at me saying this, but I've seen it a bazillion times and I feel very confident about this, when an existing client says they want to get on the video with you because they're on a trip or because they're moving into a different part of the state, which is a little different because that means your relationship is probably going to continue online for the foreseeable future, as opposed to just being a couple sessions. The advantage is, though, you know the client well. You have a strong familiarity with what they need from you.  
For example, you may know if this is the kind of person where you need to be able to closely monitor their facial expressions, like their micro-expressions, and their facial expressions, and their movements. Or if it's someone where you could just be doing this on the phone, even, and their voice is really all you need, or it's most of what you need. We know when clients are like that, when clients aren't like that. You can make that evaluation of how appropriate or how easy it will be to switch to a situation where it's, say, you can only see their head and their shoulders, and it's in two dimensions because it's in video. Or sometimes they may set up their camera so you can see their whole body, but then they're small on your screen. There's a give and take with those things, right? When you know your clients well, then it's easier to do that transition without having a lot of your own skills, or at least without having a lot of practice.  
Rob: Right.  
Roy: But, there still is actually a lot of stuff involved in doing tele-mental health properly. It's not just getting the right software and going. I would not advise somebody, just thinking of it as just getting the right software and then calling the rest of it good, even if you are working with an existing client that you know well.  
Rob: They should definitely listen to our tele-mental health episode.  
Roy: They definitely should do so. Also, read the free articles on my website, at the very least, because those also give a pretty solid introduction to the main legal ethical issues.  
Rob: You hinted there that some people might chafe at what you just said, are you suspecting that those are the people who've done research that show that tele-mental health can actually be just as efficacious as in-person counseling? Is that what you're hinting at?  
Roy: No, no, I was saying some might chafe at me implying that if you're working with a client you already know, that you may not need to be as rigorous about learning all the standards.  
Rob: Oh, okay. Who would chafe at that?  
Roy: Well, various people might say that I'm encouraging people to not really expand their scope of practice properly, like saying to them, practice outside your scope of practice is okay.  
Rob: I don't hear you saying that at all, I hear you saying-  
Roy: I know you don't.  
Rob: Yes, you're just saying you would have a little bit of an advantage-  
Roy: Yeah.  
Rob: Yeah, okay.  
Roy: It's a safer context for learning it.  
Rob: Yes, absolutely, people still need to make sure they understand the implications of providing telehealth, sure.  
Roy: Right, right, exactly. Yeah. Yeah. My experience with people is that when you're working with a client that we often categorize as a worried well, in the sense that there's not significant crisis danger or other emergent danger, and you're very aware of that, and that is the par for the course for this client, that's a great client to learn online work with. Where your errors are less likely to have a dramatic effect.  
Rob: Right.  
Roy: Where you already have a strong therapeutic relationship that can withstand errors to the relationship.  
Rob: Okay.  
Roy: Such as the video cutting out on you in the middle of an important intervention.  
Rob: Right.  
Roy: Something like that. If the person's able to take that in stride because you have such a strong relationship, that's a much better circumstance for learning those lessons of how you prevent video from cutting out on you in the middle. That's the kind of thing that can take time to learn, even though certainly you and I can teach people to do it, it still takes time.  
Rob: Sure. Okay. Well, with that said, who would you say would be well-positioned to hang a shingle, as you were saying, to take clients on-  
Roy: Oh yeah.  
Rob: ... that aren't already current clients? That will start and stay as virtual clients, if you will.  
Roy: Right. I think that case, you want to make sure you get the training. You want to make sure that ... Now, what the training is kind of varies depending on who you're talking to. Usually the basic level of training is at least understanding tech and security and privacy, and how the tech works. Which, certainly, our site has really probably some of the best courses you can get on that. Then tele-mental health, though, has a bunch of stuff in it like, do you know how to handle a crisis or set up situations in order to manage crises properly? Keeping in mind that, that's something you have to do for every region where you have a client, not just do it once, but ... For example, yeah, maybe you know how to call 9-1-1 in the state where your client is, but have you accounted for the fact that they're out in a rural area and it takes an hour for an ambulance to get there?  
Rob: Right.  
Roy: That's the kind of thing you want to make sure you know how to do. A lot of the standards are actually kind of those things where you're like, "Duh, that makes sense," once you learn it, but you didn't think of it until someone told you. There's a lot of that going on in tele-mental health and so it's a good thing to make sure you learn those, and practice with your tech really well. If you're trying to form the relationships online, the new therapeutic relationship, the baby therapeutic relationship, won't tolerate those therapeutic breaches, as well. The breaches can be caused by problems with the tech or problems with the internet connection. You want to learn how to do all that stuff properly so that you don't ... I had that early on, myself, I had my fifth or sixth online client, the video just got real foggy and I couldn't see that she was crying. You can guess that I couldn't see she was crying, my interventions were screwed up, and I never saw that client again. This is many years ago. Now, I'm going to say, you want to avoid that. You want to make sure you don't have that same kind of situation.  
Rob: Can I throw one of my wacky analogies at you?  
Roy: Yeah, totally.  
Rob: I always have these wacky analogies come up as you're talking about things. The one that was coming up as you're talking about this is, you don't want to go on Iron Chef having never cooked for people before.  
Roy: Yes. Yeah, right. That's good.  
Rob: Or the Cupcake Bake Off and you've never baked cupcakes before.  
Roy: Right.  
Rob: You've never done it for an actual chef or audience, or what have you.  
Roy: Right. Right. That might be ... In some ways, that might be even more extreme, because I don't know that it's necessarily that far out of someone's scope of competence, but-  
Rob: Sure.  
Roy: ... certainly the using the tech part is like that, yeah. Right. Luckily, these days, the video software available to us does a much better job of preventing that problem I had, where the video went fuzzy and I couldn't see tears, that was back in like 2010.  
Rob: Right.  
Roy: These days, it's a lot better.  
Rob: The olden days.  
Roy: The olden days, exactly. Still, you want to make sure you and your clients are well prepped to do things like turn off all the other things that are using the internet, or choose the right video software based on the population you're going to work with. In my case, a big reason I use VSee is because my people are across the Pacific Ocean, so I need the software that's good at bad internet connections. You want to be able to do things like that because you're going to depend on your tele-mental health skills and equipment to make sure you don't screw up the therapeutic relationship formation, and also screw up your assessment of the person's psychological state.  
Rob: So, apart from listening to our tele-mental health episode and reading all the free helpful articles on Person Centered Tech, and considering doing training if they're going forward, is there a magic question people can ask themselves to decide whether they want to delve into the realm of tele-mental health in some fashion?  
Roy: How much do you dig the idea of playing around with the tech until you're good at it, and how much are you into proactive networking marketing? Like network marketing, because that's the other thing we didn't say yet is that if you want to grow a tele-mental health practice, you really need to connect with champions who send clients to you.  
Rob: Yes.  
Roy: You need to connect with someone who has a bunch of people in need, basically have a big demand, and then you come along and give them a supply. That means that you need to come to them and tell them who you are, and get them listening to you, and then convince them that in order to meet the demand they have. Maybe they're a person who's in charge of mental health in a community, or even law enforcement in a community that's rural and doesn't have enough therapists around, or maybe they're actually a corporate person who knows that their workers who work in remote places need therapists, in a place where therapy is not normal or people don't speak English. Maybe it's any of those kinds of things, there's a huge variety of those kinds of things.  
They don't always know that you have the supply for their demand because you can supply it remotely. They don't always know that and so you need to get to them and let them know you're there, and that's the kind of work it takes to really make a tele-mental health practice work, unless you already know of such a person or organization in your area that's looking for online therapists. If you don't like doing that networking, if it's really hard for you, then it might be hard to go hang a shingle as a tele-mental health therapist, because it's what you've got to do.  
Rob: You can still do it as the adjunct, but if you're actually going to try to build and grow a piece of your practice where you're gaining virtual clients right off the bat, then that's an important question, it's a great question. All right.  
Roy: Yeah.  
Rob: So, we've given people a great list of things to do to awesomify their practice for 2018.  
Roy: Yeah.  
Rob: Everything from evaluating how their current tools and plans are taking them toward their practice that they envision, to managing their online reputation, to thinking about whether or not they want to incorporate tele-mental health, I think that's a pretty good list.  
Roy: That's a pretty good list, especially for 2018. Very techy, very modern, I like it.  
Rob: Very timely, yes.  
Roy: All right, but I think that's, speaking of time, I think that's about all we have time for this month.  
Rob: It always flies by.  
Roy: It does, doesn't it?  
Rob: It does. We'll just have to keep doing them.  
Roy: Okay. We'll do that, we'll just have another one next month.  
Rob: Let's do it.  
Roy: Okay.  
Rob: See you then.  
Roy: All right, see you then, Rob.  
Announcer: Thank you for tuning in to Therapy Tech with Rob and Roy. This episode has been sponsored by Hushmail, the secret to simple, secure communication. Episode notes and helpful resources can be found at Until next time, may you experience abundance in life and in your cellular data plan.  


  1. THIS WAS SO FUN!!!!!!

    Thank you guys for inviting me to hang out with you two!

    Your energy ROCKS!

    I so respect the work that you do, the men that you are, the creativity (and geekiness) that you bring, and the effort you put into lifting therapists up in the many ways that you do!

    TherapyTech with Rob & Roy is just one more example of those things.

    1. Roy Huggins says:

      We seriously loved having you here!

    2. RobReinhardt says:

      Thank YOU, Tamara and we are completely serious that you will need to join us again as we had such a blast!

  2. Craig Loving says:

    Awesome podcast!

    Good work Rob and Roy.

    Thanks, Tamara, for your timely insights.

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