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5 Things to Know Before Starting a Practice

5 Things to Know Before Starting a Practice

Contextual Behavioral Science

5 Things to Know Before Starting a Practice

Starting a practice in the mental health field can be tricky and intimidating, but there are some things you need to keep in mind to ensure that your business gets off to the right start. These five points are important to know before starting a mental health practice, so you can make sure your business has the best chance of succeeding from the beginning.

1) Get Educated
While it is important to have an idea of what you’re doing when starting your practice, there is also value in getting educated. You should learn about how insurance companies work, how to make money and most importantly, how to get clients. There are many different ways of approaching these tasks but be sure you are on track before you open your doors. You don’t want take your first client and realize that you aren’t ready! When starting a business or practicing any profession for that matter, knowledge is power. So as you embark on your new endeavor, know exactly what steps need to be taken and why they are necessary. If you understand why certain things need to happen at certain times during startup, then making decisions will become easier down the road.

2) Figure Out Your Mission
When starting your own practice, it’s crucial to figure out why you want to start it. Is it because you’re passionate about helping people? Do you have financial problems? Or do you just love meeting new people and talking about your interests for hours on end? Figure out what drives you so that in those moments of doubt, or just when things get rough (and they will), you can remind yourself of why you started practicing in the first place. You may also need to adjust your mission statement as time goes on, but getting started is an important step in itself. And don’t forget to share with others why you started practicing! Maybe they too would like to join you!

3) Set up your Website
Setting up your website is key for making sure you’re able to convey who you are and what you do to potential clients. Whether you’re setting up a full-blown site or simply having something created on WordPress, having an online presence is crucial for any mental health professional hoping to start their own practice. But if one thing that working with tech companies has taught me, it’s that simple websites often work best. If your website doesn’t look good, no one will want to hire you—no matter how great of a therapist you are. And while I think it’s important to have some semblance of design in place (to make sure people actually read what you write), overthinking things can be counterproductive. For example, I once spent hours agonizing over font choice before realizing that people don’t care about fonts—they care about helping themselves feel better. So, my advice: keep it simple. Make sure you include information about yourself and your services so that people know exactly what they’re getting when they come to see you. Beyond that, just let nature take its course! You might be surprised by how many new clients start coming through your door after just a few weeks or months.

4) Branding
If you’re serious about starting your own mental health practice, there are several things you need to do right out of the gate. Think branding and marketing. Consider what type of service offerings, location, facilities and patient care you want and be sure that they’re all tied together in one cohesive package. Most importantly, make sure that your brand is unique in some way from other providers in your area. Otherwise, why would anyone choose you over someone else? There are thousands of mental health professionals across America and many patients have no idea how to find them; having a strong, recognizable brand will help you stand out from the crowd. In addition, get started on social media channels as soon as possible; these sites are great for reaching potential clients and keeping up with their needs and concerns. Finally, put together a website to establish credibility with patients—and prospective patients—right away. Make it professional-looking without being too fancy or complicated (remember: most people looking for services aren’t web designers). When people visit your site, make sure they can easily access information about fees, insurance policies and payment options.

5) Marketing
As you start your practice, remember that you are your own best marketing tool. Other mental health professionals and potential clients will want to know why they should pick you over another therapist. Start by creating a website where people can learn about your practice, background, and beliefs. It should feature information about your specialty areas and any treatment approaches that are unique or different from other therapists in your area. Keep in mind that social media is also a powerful marketing tool for both finding and communicating with potential clients. The more active you are on Facebook, Twitter, LinkedIn, and Instagram (and others), the more opportunities there will be for people to learn about your practice.

Starting a Practice that includes Clinical Behavior Analysis
There are many aspects to simply starting a practice, all of these become somewhat more complicated if you are moving into Clinical Behavior Analysis – either as a behavior analyst or a dually licensed clinician. You need to strongly consider your scope, limitations, regulations in your area, the availability of on-team multi-disciplinary staff to support you, and/or external consultation and supervision. Each of the above areas of focus will also need to be considered from the perspective of starting this unique type of practice or launching a business with an integrated practice team. If you’d like to know more about these topics, visit our Clinical Behavior Analysis series in the “Shop” or reach out to us.

 

Angela Coreil, PhD

Angela Coreil, PhD

Consultant and Educator

Angela J. Coreil, PhD works with individuals and organizations to promote better connected, purposeful, and effective living through behavior analytic principles. She has over a decade of clinical experience treating human suffering and promoting human excellence using Acceptance and Commitment Therapy (ACT) and other behavioral therapies. She now focuses on the promotion and translation of Clinical Behavior Analysis as a way to improve our science.

What is ‘clinically relevant behavior’: Sign or sample

What is ‘clinically relevant behavior’: Sign or sample

Contextual Behavioral Science

As discussed by Ollendick et al. (2004), abnormal and clinically-relevant behavior can be viewed as either a “sample” or as a “sign.” To what extent does this difference, in turn, make a difference in the assumed temporal and situational consistency of such behavior?

Whether you view abnormal and clinically-relevant behavior as a “sample” or a “sign” makes a significant difference in whether you consider such behavior to be consistent over time and in various situations. If a behavior is seen as only a “sample” of a person’s behavior then there is no expectation that this behavior will be consistent over time or in different situations. When behavior is only said to be only a “sample” the implication is that you expect variation in the behavior. If the behavior is thought of as a “sign”, however, the implication is that the behavior is only an indication of an underlying trait or pathology which implies that the behavior should be more constant through time and situations. From this view as long as the underlying pathology, trait, etc. is present then behavioral “signs” of the underlying construct should also be present. In the relation to psychological problems this “sign” conceptualization, however, is most often a circular or reifying argument. A “sign” behavior indicates a “disorder” when a “disorder” only indicates a collection of symptoms. This conceptualization provides no particular “cause” for the behavior other than itself. This conceptualization is an artifact of using the methods of physicians to understand physical disease to understand human behavior.

The understanding of behavior as a “sample” vs a “sign” also impacts how problem behavior is conceptualized and in turn how assessment is conducted. If the behavior is only a “sample” of a person’s behavior at a certain time in a certain situation than an assessment of the person’s behavior in other situations is likely to be important. If the behavior is a “sign” then assessment over one time period in one situation is more acceptable because the behavior is assumed to be stable as long the “disorder” is constant. Assessment of “sample” behavior may also involve a less predetermined route than assessment of “sign” behavior. As behavior seen as a “sample” implies that there may be a wide variety of other problem behaviors that may exist with the target behavior. Thus, assessment may include any route of questioning, observing etc. that helps the clinician learn about all problem behavior and any possible relationships between the environment and problem behaviors. Because the behavior is expected to vary by situation, factors related to the situation may more likely be considered part of the conceptualization of the problem and should be assessed. If behavior is conceptualized as an “sign”, however, the behavior is related to internal factors and assessment is more likely to focus on assessing for other problem behaviors that are understood to cluster to indicate the underlying pathology. Assessment of environmental/situational factors is also less important if the behavior is understood to indicate pathology as the person’s behavior should continue to indicate the pathology across situations. In other words, assessment from a “sample” behavior perspective is more likely to be all-inclusive in assessing what other behaviors are present and what factors may be causing the problem behavior. Assessment from behavior as a “sign” perspective is more likely to be limiting in the sense that the clinician begins by looking specifically for behaviors that indicate a disorder and is more likely to ignore situational factors in the behavior and understand the “disorder” indicated the cause of the problem behavior.

 

Angela Coreil, PhD

Angela Coreil, PhD

Consultant and Educator

Angela J. Coreil, PhD works with individuals and organizations to promote better connected, purposeful, and effective living through behavior analytic principles. She has over a decade of clinical experience treating human suffering and promoting human excellence using Acceptance and Commitment Therapy (ACT) and other behavioral therapies. She now focuses on the promotion and translation of Clinical Behavior Analysis as a way to improve our science.

Relational Frame Theory (RFT)- What’s the big deal?

Relational Frame Theory (RFT)- What’s the big deal?

Contextual Behavioral Science

by Angela Coreil, PhD (Original post to angela.cathey.com June, 2016)


So, what’s the deal with RFT? Isn’t this just another theory to add to your dusty reading stack? No. Put it on top, like yesterday.

RFT is a theory of how relating becomes a part of our processing of the world. We are richly hooked into our very verbal sense-making of the world. Our internal verbal-ish history can become a more predominate shaper of perception, in the moment, than even previous respondent or operant conditioning. Move over Bandura and those ridiculous Bobo dolls, we’re onto something big.

Yes, it’s a big deal. HUGE. The most coherent, expansive, and useful theories we have in psychology allow us to predict and influence behavior are operant and respondent conditioning-based. Functional Analysis (FA) is a cornerstone of modern behaviorist therapies and yet we’re saying that even if you account for all the ‘external’ context you could be missing the most important variable in the room.

Our ideographic and collective history of verbal relating influences our perception. Note: this is not the same as ‘language’. What we’re talking about is a hodgepodge mix of learning history, language, internal rules, sensations, etc. that people often hear as “language”). It’s not about “language” it’s about relational history that gets heavily influenced by language because that’s the framework we see the world through. Just think… when is the last time that voice in your head actually shut up? Never? We are verbal and that verbal-ness is often key in high-jacking a human’s response to the contingencies in the room. Further, we understand that the specific ways and frequencies in which we relate things can influence our perception, behavior, emotion in predictable ways.

So, this verbal relational soup of history is on-going and heavily influencing our contact with the world. This is pretty profound, but in itself, esoteric at best. Like knowledge of quantum mechanics and M-theory it’s cool but what can we DO with it? That’s where we really start getting to the sexiness inherent in RFT. RFT describes properties of relating such that you can walk back and forth with empirical logic from observation, to assessment, to intervention strategy.

As a clinician and researcher, I’ve done most of my work in exposure-based treatment of anxiety and related issues. In treating severe anxiety at the Intensive Outpatient and Partial Hospitalization levels I saw clients on a daily basis for hours, for months at a time.  It was doing this level of treatment where I saw the quirks of change, or lack of it, in my client’s behavior the best. It was here that I kept running across quirks in treatment and assessment that were not well explained in the literature. One of those phenomena was that what tended to most amp up or dampen exposure intensity within OCD and PTSD wasn’t what you’d expect. I found that often the stimuli or experiences that were most painful for people were linked to their values or their sense of themselves, others, or the world. I also noticed that sometimes hierarchies needed to include exposure to stimuli that just didn’t fit into normal models of fear conditioning (see exposures to milkshakes, umbrellas, The Doors, and emotions themselves). And, weirder yet – that a change in context could sometimes seemingly result in immediate ‘habituation’.

I returned to Relational Frame Theory and behavior analysis because training across modalities still left me with insufficient explanation for what I saw. Take the example of values intensifying exposure via values. Yes, that might be covered by ACT mid-level terms but it doesn’t give you a full picture. If we consider properties inherent in various types of ‘framing’ that might be at hand in values we not only know what to do to move this material with the client but we also have indications of other, less intuitive things that might also be amply or de-amplify an exposure (outside of values). We can reasonably say that hierarchical framing is likely at hand. Knowing this, we might also be able to find other material that moves exposures up and down the hierarchy simply by understanding the types of relations that are most predominant in driving the client’s experience. 

What’s more, you can do this underneath the level of therapeutic orientation and diagnosis. Everything becomes about relations that we can influence without clinging to our own preferred tools. (Yes, that’s right. I’m a behaviorist and I believe those psychoanalytic folks may even be getting it right too – just differently. None of us has a total lock-down on effective treatment.

I see this as the real beauty and possibility of Relational Frame Theory and behavior analysis – the promise that unification of psychology – across all areas influenced by human thought, across levels of analysis, across basic and applied, across therapeutic orientation, and across diagnoses might be possible. That we may just be able to move forward from the elaborated mess of opposing theories, big egos, and lack of cooperation that we currently call ‘psychology.’

Are you interested in learning more about RFT and behavior analysis? Let us know in the comments or consider taking one of our online training events.

 

Angela Coreil, PhD

Angela Coreil, PhD

Consultant and Educator

Angela J. Coreil, PhD works with individuals and organizations to promote better connected, purposeful, and effective living through behavior analytic principles. She has over a decade of clinical experience treating human suffering and promoting human excellence using Acceptance and Commitment Therapy (ACT) and other behavioral therapies. She now focuses on the promotion and translation of Clinical Behavior Analysis as a way to improve our science.

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